Present assessment of myocardial viability by nuclear imaging
Autor: | Richard C. Brunken, C. Oliver Wong, William J. MacIntyre, Shanker Raja, Gopal B. Saha, Raymundo T. Go, Eric Q. Chen |
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Rok vydání: | 1996 |
Předmět: |
Technetium Tc 99m Sestamibi
Fluorine Radioisotopes Nuclear imaging chemistry.chemical_element Deoxyglucose Coronary artery disease Fluorodeoxyglucose F18 medicine Humans Radiology Nuclear Medicine and imaging In patient Tomography Emission-Computed Single-Photon Oxidative metabolism medicine.diagnostic_test business.industry Myocardium Heart medicine.disease Thallium Radioisotopes chemistry Thallium Artifacts business Nuclear medicine Rubidium Radioisotopes Perfusion Emission computed tomography Tomography Emission-Computed |
Zdroj: | Seminars in Nuclear Medicine. 26:315-335 |
ISSN: | 0001-2998 |
DOI: | 10.1016/s0001-2998(96)80007-9 |
Popis: | Prospective delineation of viable from nonviable myocardium in patients with coronary artery disease is an important factor in deciding whether a patient should be revascularized or treated medically. Two common techniques — single-photon emission computed tomography (SPECT) and positron-emission tomography (PET)—are used in nuclear medicine using various radiopharmaceuticals for the detection of myocardial viability in patients. Thallium-201 ( 201 TI) and technetium-99m ( 99m Tc)-sestamibi are the common radiopharmaceuticals used in different protocols using SPECT, whereas fluoride-18 ( 18 F)-fluorodeoxyglucose (FDG) and rubidium-82 ( 82 Rb) are most widely used in PET. the SPECT protocols involve stress/redistribution, stress/redistribution/reinjection, and rest/redistribution imaging techniques. Many studies have compared the results of 201 TI and ( 99m Tc)-sestamibi SPECT with those of FDG PET; in some studies, concordant results have been found between delayed thallium and FDG results, indicating that 201 TI, although considered a perfusion agent, shows myocardial viability. Discordant results in a number of studies have been found between sestamibi and FDG, suggesting that the efficacy of sestamibi as a viability marker has yet to be established. Radiolabeled fatty acids such as iodine-123 ( 123 I)-para-iodophenylpentadecanoic acid and carbon-11 ( 11 C)-palmitic acid have been used for the assessment of myocardial viability with limited success. 11 C-labeled acetate is a good marker of oxidative metabolism in the heart and has been used to predict the reversibility of wall motion abnormalities. ( 18 F)-FDG is considered the marker of choice for myocardial viability, although variable results are obtained under different physiological conditions. Detection of myocardial viability can be greatly improved by developing new equipment and radiopharmaceuticals of better quality. |
Databáze: | OpenAIRE |
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