GATED METABOLIC POSITRON-EMISSION-TOMOGRAPHY (GAPET) OF THE MYOCARDIUM - F-18 FDG-PET TO OPTIMIZE RECOGNITION OF MYOCARDIAL HIBERNATION

The aim of this study was to test the feasibility of the direct measur ement of global and regional metabolic wall thickening with F-18-FDG-g ated positron emission tomography (PET) in patients with coronary arte ry disease (CAD). Based on non-invasive (ECG, echocardiography) and in vasive [cineventriculography (CVG), coronary angiography] investigatio ns, 12 patients with CAD underwent gated metabolic PET studies with F- 18-FDG. Myocardial wall thickening and wall motion analysis from short -axis horizontal and vertical long-axis slices were studied. PET-deriv ed global ejection fraction correlated with CVG-derived global ejectio n fraction (r = 0.75). Forty-eight of 72 segments investigated were no rmal (66.7%); 24 of 72 segments were abnormal (33.3%), of which 10 (41 .7%) were considered to be hibernating. Four segments were classified as partially fibrotic (16.7%) and 10 (41.7%) as entirely scar-like. Ga ted PET (8 gates, tail drop corrected) allows quantification of global and regional ejection fraction to detect metabolic wall thickening in left ventricular segments with dyskinesia on CVG due to critical CAD stenoses. By improving data analysis methods, our approach may enhance the detection of viable, hibernating myocardium before revascularizat ion. ((C) 1998 Lippincott-Raven Publishers).