Related Experiment Video
Updated: Aug 9, 2026
High-Resolution Cardiac Positron Emission Tomography/Computed Tomography for Small Animals
Published on: December 16, 2022
Prediction of functional recovery after revascularization in patients with coronary artery disease and left
Riemer H J A Slart1, Jeroen J Bax, Dirk J van Veldhuisen
1Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands. r.h.j.a.slart@nucl.umcg.nl
Insights
Gated fluorodeoxyglucose (FDG) positron emission tomography (PET) can accurately predict recovery of left ventricular function after revascularization. The study found that specific thresholds for FDG uptake and wall thickening effectively predicted improved cardiac function and remodeling.
Area of Science:
- Cardiovascular Imaging
- Nuclear Cardiology
- Cardiac Metabolism
Background:
- Traditional cardiac viability assessment combines fluorodeoxyglucose (FDG) uptake with perfusion imaging.
- Gated FDG-positron emission tomography (PET) offers a combined assessment of glucose metabolism and wall thickening (WT) for viability detection.
Purpose of the Study:
- To evaluate the predictive value of stand-alone gated FDG-PET for recovery of regional and global left ventricular (LV) function post-revascularization.
- To assess the ability of FDG uptake and WT from gated FDG-PET to predict functional recovery and reverse LV remodeling.
Main Methods:
- Thirty-eight patients with chronic coronary artery disease and LV dysfunction were included.
- Gated FDG-PET was performed to assess myocardial viability.
- Magnetic resonance imaging (MRI) was used for pre- and post-revascularization assessment of LV function and volumes.
Main Results:
- Of 213 dysfunctional segments, 62% showed functional recovery.
- A gated FDG-PET cutoff of 50% for FDG uptake predicted regional function improvement with 93% sensitivity and 85% specificity.
- A WT cutoff of 10% predicted regional function improvement with 89% sensitivity and 78% specificity.
- Improvement in LV ejection fraction was best predicted by the number of viable segments.
Conclusions:
- Gated FDG-PET, using FDG uptake thresholds (≥50%) or WT thresholds (≥10%), accurately predicts outcomes after revascularization.
- These predictions include improvements in regional and global LV function and reverse LV remodeling.
Background:
Traditionally, cardiac fluorodeoxyglucose (FDG) uptake is combined with regional perfusion for optimal evaluation of viability. Gated FDG-positron emission tomography (PET) may be an alternative technique for detection of viability because it permits combined assessment of glucose metabolism uptake and wall thickening (WT). In this study the value of FDG uptake and WT (analyzed from a stand-alone gated FDG-PET study) for the prediction of recovery of regional and global left ventricular (LV) function in patients with coronary artery disease undergoing revascularization is studied.
Methods And Results:
Thirty-eight patients with chronic coronary artery disease and LV dysfunction were included. Patients underwent gated FDG-PET to assess viability. Magnetic resonance imaging was performed before and 6 months after revascularization to assess regional and global LV function and LV volumes. Of the 213 revascularized dysfunctional segments, 133 (62%) exhibited functional recovery on follow-up magnetic resonance imaging. Receiver operating characteristic curve analysis indicated that a cutoff level for FDG uptake of 50% or greater yielded a sensitivity and specificity of 93% and 85%, respectively, on gated FDG-PET for prediction of improvement in regional function. Similarly, a cutoff level of 10% or greater for WT was optimal with a sensitivity and specificity of 89% and 78%, respectively. Improvement in LV ejection fraction was best predicted by the number of viable segments. Reverse LV remodeling could be predicted with a sensitivity and specificity of 89% and 65%, respectively, by use of FDG uptake of 50% or greater and 78% and 70%, respectively, by use of WT of 10% or greater.
Conclusion:
Accurate prediction of outcome after revascularization (including improvement in regional and global LV function and reverse remodeling) is possible with gated FDG-PET by use of a threshold of 50% or greater for FDG uptake or a threshold of 10% or greater for WT.
