[Assessment of myocardial viability by FDG-PET]

Assessment of myocardial viability is very important for identifying patients likely to benefit from coronary revascularization. Clinical studies have shown that positron emission tomography(PET) using [18F] 2-fluoro-2deoxy-D-glucose (FDG) can accurately identify patients with viable myocardium that are likely to benefit from revascularization procedures, in terms of improvement of left ventricular (LV) function, alleviation of heart failure symptoms, and improvement of long-term prognosis. Single photon emission computed tomography (SPECT) using perfusion tracers such as TL-201 and Tc99m-MIBI are useful to assess viability, but a problem is their particularly low specificity. FDG-PET has several advantages including higher sensitivity and specificity over perfusion tracers. This article will review myocardial metabolism, FDG-PET protocol, procedures, interpretive criteria and clinical applications as well as problems and limitations. The literature regarding diagnostic and prognostic information about viability using FDG-PET is summarized.