[Problems related to tracer concentration and wall thickness: pitfalls in positron CT diagnosis]

Positron emission computed tomography (PET) is regarded an excellent technique for quantitative measurements. However, its accuracy is related to the spatial resolution of the system. The relation between myocardial wall thicknesses as measured by X-ray CT or MRI and the radioactivity as measured using PET was studied in 37 patients. 1. In patients with transmural infarction, the infarcted myocardium was imaged as a region of low radioactivity. However, the myocardium usually exhibited wall thinning, so that partial volume effects must be taken into account in evaluating the radioactivity. 2. In the infarcted regions, the regions of the low radioactivity tended to be larger than those of wall thinning. 3. There were cases with the regional low radioactivity without wall thinning in myocardial infarction and in hypertrophic cardiomyopathy. Because patients with myocardial infarction frequently had regional wall thinning, it seems necessary to correct partial volume effects for the infarcted regions which differ from the normal. It was concluded that, to estimate regional myocardial blood flow or metabolism using PET, it is necessary to supplement another morphological diagnostic method to evaluate myocardial wall thickness.