Practical assessment of myocardial viability with a positron coincidence gamma camera using 18F-fluorodeoxyglucose in acute myocardial infarction. Comparison with dedicated positron emission tomography and 201Tl single photon emission computed tomography

2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG) began to be supplied commercially to our hospital, which does not have a cyclotron, in autumn of 2005. The purpose of this study was to compare the utility of a dual-head positron coincidence detection (PCD) gamma camera in the detection of myocardial viability using 18F-FDG with that of dedicated positron emission tomography (PET) and with that of thallium-201 (201Tl) single photon emission computed tomography (SPECT). A total of 15 patients (14 men and 1 woman, mean age: 60±7 years, range: 46-73) with a large acute myocardial infarction (AMI) underwent 18F-FDG PET, 18F-FDG PCD imaging after oral glucose loading (75 g) and 201Tl SPECT imaging. We divided the SPECT and PET images into a total of 20 segments, and semiquantitative visual analysis was performed by assessing regional tracer activities on a 4-point scoring system (DS): 0=normal uptake, 1=mildly reduced uptake, 2=severely reduced uptake, and 3=no uptake. We summed the DS in each patient as the total DS (TDS). The TDS of the 18F-FDG PET image was 14.4±7.7. The TDS of the 18F-FDG PCD image was 18.7±7.7. The TDS of the 201Tl SPECT image was 24.1±11.5. The TDS of the 18F-FDG PET image was significantly smaller than that of the 18F-FDG PCD image. The TDS of the 18F-FDG PET image was significantly smaller than that of the 201Tl SPECT image. The TDS of the 18F-FDG PCD image was significantly smaller than that of the 201Tl SPECT image. The findings of the project suggest that 18F-FDG PCD is a good modality based on its accuracy, convenience, and cost-performance for detecting myocardial viability in hospitals that do not have a PET system. (author)