F18-fluorodeoxglucose single-photon emission computed tomography predicts functional outcome of dyssynergic myocardium after surgical revascularization

Jeroen J. Bax, Jan H. Cornel, Frans C. Visser, Paolo M. Fioretti, Johannes M. Huitink, A. Van Lingen, Gerrit W. Sloof, Cees A. Visser

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background. Prediction of functional recovery after revascularization is possible with positron emission tomography and F18-fluorodeoxyglucose (FDG). Recently, the use of FDG in combination with single-photon emission computed tomography (SPECT), with 511 keV collimators, has been proposed to allow more widespread use of FDG. In the current study we aimed to predict improvement of regional left ventricular function after surgical revascularization with FDG and SPECT. Methods and Results. Twenty-seven patients with regional wall motion abnormalities (on echocardiography) underwent early thallium-201 (Tl-201) SPECT to assess perfusion and FDG SPECT to assess regional glucose uptake. The left ventricular myocardium was divided into 13 segments. For each segment, tracer uptake was evaluated visually (with the use of a 4-point scoring system) by consensus of two observers. Myocardial viability was determined in dyssynergic segments on echocardiography and defined as normal perfusion or increased FDG uptake in a perfusion defect (mismatch). Absence of viability was defined as a perfusion defect without increased FDG uptake (match). Improvement of regional wall motion was assessed 3 months after revascularization. In the group of segments that were viable on FDG/Tl-201 SPECT (n = 64), the segmental wall motion score decreased from 1.4 ± 0.5 to 0.6 ± 0.7 (p < 0.01), whereas the segmental wall motion score remained unchanged in nonviable segments (n = 72): 1.6 ± 0.5 versus 1.5 ± 0.6 (not significant). Forty-six (72%) of the 64 segments that were viable on FDG/Tl-201 SPECT demonstrated improved contractile function after coronary revascularization. In contrast, only 7 (10%) of 72 nonviable segments on FDG/Tl-201 SPECT showed improvement in function after revascularization (p < 0.01 versus viable segments). The sensitivity, specificity, and positive and negative predictive values were 87%, 78%, 72%, and 90%, respectively. Conclusion. This study shows that FDG/Tl-201 SPECT can identify patients who improve in regional ventricular function after revascularization.

Original languageEnglish
Pages (from-to)302-308
Number of pages7
JournalJournal of Nuclear Cardiology
Volume4
Issue number4
DOIs
Publication statusPublished - 1 Jan 1997

Cite this

@article{0d5067c9f0da40ebbe311a83ea373b8e,
title = "F18-fluorodeoxglucose single-photon emission computed tomography predicts functional outcome of dyssynergic myocardium after surgical revascularization",
abstract = "Background. Prediction of functional recovery after revascularization is possible with positron emission tomography and F18-fluorodeoxyglucose (FDG). Recently, the use of FDG in combination with single-photon emission computed tomography (SPECT), with 511 keV collimators, has been proposed to allow more widespread use of FDG. In the current study we aimed to predict improvement of regional left ventricular function after surgical revascularization with FDG and SPECT. Methods and Results. Twenty-seven patients with regional wall motion abnormalities (on echocardiography) underwent early thallium-201 (Tl-201) SPECT to assess perfusion and FDG SPECT to assess regional glucose uptake. The left ventricular myocardium was divided into 13 segments. For each segment, tracer uptake was evaluated visually (with the use of a 4-point scoring system) by consensus of two observers. Myocardial viability was determined in dyssynergic segments on echocardiography and defined as normal perfusion or increased FDG uptake in a perfusion defect (mismatch). Absence of viability was defined as a perfusion defect without increased FDG uptake (match). Improvement of regional wall motion was assessed 3 months after revascularization. In the group of segments that were viable on FDG/Tl-201 SPECT (n = 64), the segmental wall motion score decreased from 1.4 ± 0.5 to 0.6 ± 0.7 (p < 0.01), whereas the segmental wall motion score remained unchanged in nonviable segments (n = 72): 1.6 ± 0.5 versus 1.5 ± 0.6 (not significant). Forty-six (72{\%}) of the 64 segments that were viable on FDG/Tl-201 SPECT demonstrated improved contractile function after coronary revascularization. In contrast, only 7 (10{\%}) of 72 nonviable segments on FDG/Tl-201 SPECT showed improvement in function after revascularization (p < 0.01 versus viable segments). The sensitivity, specificity, and positive and negative predictive values were 87{\%}, 78{\%}, 72{\%}, and 90{\%}, respectively. Conclusion. This study shows that FDG/Tl-201 SPECT can identify patients who improve in regional ventricular function after revascularization.",
keywords = "F18-fluorodeoxyglucose, Myocardial viability, Single-photon emission computed tomography",
author = "Bax, {Jeroen J.} and Cornel, {Jan H.} and Visser, {Frans C.} and Fioretti, {Paolo M.} and Huitink, {Johannes M.} and {Van Lingen}, A. and Sloof, {Gerrit W.} and Visser, {Cees A.}",
year = "1997",
month = "1",
day = "1",
doi = "10.1016/S1071-3581(97)90108-2",
language = "English",
volume = "4",
pages = "302--308",
journal = "Journal of Nuclear Cardiology",
issn = "1071-3581",
number = "4",

}

F18-fluorodeoxglucose single-photon emission computed tomography predicts functional outcome of dyssynergic myocardium after surgical revascularization. / Bax, Jeroen J.; Cornel, Jan H.; Visser, Frans C.; Fioretti, Paolo M.; Huitink, Johannes M.; Van Lingen, A.; Sloof, Gerrit W.; Visser, Cees A.

In: Journal of Nuclear Cardiology, Vol. 4, No. 4, 01.01.1997, p. 302-308.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - F18-fluorodeoxglucose single-photon emission computed tomography predicts functional outcome of dyssynergic myocardium after surgical revascularization

AU - Bax, Jeroen J.

AU - Cornel, Jan H.

AU - Visser, Frans C.

AU - Fioretti, Paolo M.

AU - Huitink, Johannes M.

AU - Van Lingen, A.

AU - Sloof, Gerrit W.

AU - Visser, Cees A.

PY - 1997/1/1

Y1 - 1997/1/1

N2 - Background. Prediction of functional recovery after revascularization is possible with positron emission tomography and F18-fluorodeoxyglucose (FDG). Recently, the use of FDG in combination with single-photon emission computed tomography (SPECT), with 511 keV collimators, has been proposed to allow more widespread use of FDG. In the current study we aimed to predict improvement of regional left ventricular function after surgical revascularization with FDG and SPECT. Methods and Results. Twenty-seven patients with regional wall motion abnormalities (on echocardiography) underwent early thallium-201 (Tl-201) SPECT to assess perfusion and FDG SPECT to assess regional glucose uptake. The left ventricular myocardium was divided into 13 segments. For each segment, tracer uptake was evaluated visually (with the use of a 4-point scoring system) by consensus of two observers. Myocardial viability was determined in dyssynergic segments on echocardiography and defined as normal perfusion or increased FDG uptake in a perfusion defect (mismatch). Absence of viability was defined as a perfusion defect without increased FDG uptake (match). Improvement of regional wall motion was assessed 3 months after revascularization. In the group of segments that were viable on FDG/Tl-201 SPECT (n = 64), the segmental wall motion score decreased from 1.4 ± 0.5 to 0.6 ± 0.7 (p < 0.01), whereas the segmental wall motion score remained unchanged in nonviable segments (n = 72): 1.6 ± 0.5 versus 1.5 ± 0.6 (not significant). Forty-six (72%) of the 64 segments that were viable on FDG/Tl-201 SPECT demonstrated improved contractile function after coronary revascularization. In contrast, only 7 (10%) of 72 nonviable segments on FDG/Tl-201 SPECT showed improvement in function after revascularization (p < 0.01 versus viable segments). The sensitivity, specificity, and positive and negative predictive values were 87%, 78%, 72%, and 90%, respectively. Conclusion. This study shows that FDG/Tl-201 SPECT can identify patients who improve in regional ventricular function after revascularization.

AB - Background. Prediction of functional recovery after revascularization is possible with positron emission tomography and F18-fluorodeoxyglucose (FDG). Recently, the use of FDG in combination with single-photon emission computed tomography (SPECT), with 511 keV collimators, has been proposed to allow more widespread use of FDG. In the current study we aimed to predict improvement of regional left ventricular function after surgical revascularization with FDG and SPECT. Methods and Results. Twenty-seven patients with regional wall motion abnormalities (on echocardiography) underwent early thallium-201 (Tl-201) SPECT to assess perfusion and FDG SPECT to assess regional glucose uptake. The left ventricular myocardium was divided into 13 segments. For each segment, tracer uptake was evaluated visually (with the use of a 4-point scoring system) by consensus of two observers. Myocardial viability was determined in dyssynergic segments on echocardiography and defined as normal perfusion or increased FDG uptake in a perfusion defect (mismatch). Absence of viability was defined as a perfusion defect without increased FDG uptake (match). Improvement of regional wall motion was assessed 3 months after revascularization. In the group of segments that were viable on FDG/Tl-201 SPECT (n = 64), the segmental wall motion score decreased from 1.4 ± 0.5 to 0.6 ± 0.7 (p < 0.01), whereas the segmental wall motion score remained unchanged in nonviable segments (n = 72): 1.6 ± 0.5 versus 1.5 ± 0.6 (not significant). Forty-six (72%) of the 64 segments that were viable on FDG/Tl-201 SPECT demonstrated improved contractile function after coronary revascularization. In contrast, only 7 (10%) of 72 nonviable segments on FDG/Tl-201 SPECT showed improvement in function after revascularization (p < 0.01 versus viable segments). The sensitivity, specificity, and positive and negative predictive values were 87%, 78%, 72%, and 90%, respectively. Conclusion. This study shows that FDG/Tl-201 SPECT can identify patients who improve in regional ventricular function after revascularization.

KW - F18-fluorodeoxyglucose

KW - Myocardial viability

KW - Single-photon emission computed tomography

UR - http://www.scopus.com/inward/record.url?scp=0030610954&partnerID=8YFLogxK

U2 - 10.1016/S1071-3581(97)90108-2

DO - 10.1016/S1071-3581(97)90108-2

M3 - Article

VL - 4

SP - 302

EP - 308

JO - Journal of Nuclear Cardiology

JF - Journal of Nuclear Cardiology

SN - 1071-3581

IS - 4

ER -