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Continuous Blood Sampling in Small Animal Positron Emission Tomography/Computed Tomography Enables the Measurement of the Arterial Input Function
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Continuous Blood Sampling in Small Animal Positron Emission Tomography/Computed Tomography Enables the Measurement of the Arterial Input Function

Published on: August 8, 2019

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Functional and metabolic improvement after coronary intervention for non-viable myocardium detected by 18F

Kenji Fukushima1, Hiroyuki Arashi2, Yuichiro Minami2

  • 1Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan.

Journal of Cardiology Cases
|August 24, 2019
PubMed

Insights

Revascularization improved cardiac function in a patient with myocardial infarction. Early assessment of myocardial viability using FDG-PET may underestimate recovery potential in pre-chronic infarction.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Interventional Cardiology

Background:

  • Myocardial infarction (MI) can lead to significant left ventricular dysfunction.
  • Assessing myocardial viability is crucial for guiding treatment decisions after MI.
  • Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) is a common method for viability assessment.

Observation:

  • A 64-year-old man with suspected myocardial infarction showed reduced cardiac function and anterior dyskinesis.
  • Initial imaging suggested a large, non-viable anterior myocardial infarction.
  • Percutaneous coronary intervention (PCI) with stenting was successfully performed.

Findings:

  • Six months post-PCI, left ventriculography revealed significant recovery of global cardiac function.
  • Improved wall motion and recovered glucose metabolism were observed in the previously diagnosed non-viable myocardium.
  • This suggests that 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) may underestimate viability in the early post-infarction phase.

Implications:

  • Revascularization can significantly improve cardiac function and prognosis in patients with myocardial infarction and left ventricular dysfunction.
  • It may be premature to definitively assess myocardial viability using FDG-PET in the pre-chronic stage (less than one month) after infarction.
  • Further research is needed to refine viability assessment in the early post-myocardial infarction period.

Keywords:
18Fluorodeoxyglucose positron emission tomographyCardiac imagingCoronary interventionFDG, 18F fluorodeoxyglucoseMyocardial infarctionPCI, Percutaneous Coronary InterventionPET, Positron Emission TomographyQGS, Quantitative Gated Single Photon Emission TomographySPECT, Single Photon Emission Computed TomographyTL, thallium-201Tc-99m, Technetium-99mViability

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