Electrocardiographic-gated dual-isotope simultaneous acquisition SPECT using 18F-FDG and 99mTc-sestamibi to assess myocardial viability and function in a single study
Electrocardiographic-gated dual-isotope simultaneous acquisition SPECT using 18F-FDG and 99mTc-sestamibi to assess myocardial viability and function in a single study
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DOI：
10.1007/s00259-004-1668-9
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发表时间：
2005-02
影响因子：
9.1
通讯作者：
I. Matsunari;Sugako Kanayama;T. Yoneyama;M. Matsudaira;K. Nakajima;J. Taki;S. Nekolla;N. Tonami;K. Hisada
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文献类型：
--
作者：
I. Matsunari;Sugako Kanayama;T. Yoneyama;M. Matsudaira;K. Nakajima;J. Taki;S. Nekolla;N. Tonami;K. Hisada
目的18F-氟脱氧葡萄糖（FDG）和99 mTc-甲氧基异丁基异腈（99 mTc-Sestamibi）双同位素同步采集单光子发射计算机断层扫描（DISA SPECT）可同时评估葡萄糖利用率和灌注，因此在检测存活心肌方面具有吸引力。该方法的另一个潜在益处是可以通过ECG门控来测量左心室（LV）功能。本研究的目的是检验心肌存活性和LV功能可通过单次ECG门控18F-FDG/99 mTc-sestamibi DISA SPECT研究进行评估的假设，方法对33例有心肌梗死史的患者行心电门控18F-FDG/99 mTc显像，并与18F-FDG/13 N-NH3正电子发射断层显像（PET）和磁共振成像（MRI）进行比较。在一天内进行Sestamibi DISA SPECT和18F-FDG/13 N-ammonia PET。其中，25例患者还接受了电影MRI，以评估LV功能。将左室心肌分为9个区域，并使用半定量视觉评分系统以及定量分析将每个区域分为存活或瘢痕。结果DISA SPECT与PET显像的存活率无论是直观分析还是定量分析，均具有良好的一致性（90- 96%，κ 0. 74 ~ 0. 85）。此外，虽然门控SPECT测量的全球和区域LV功能与MRI一致，99 mTc-sestamibi表现出更密切的相关性与MRI比did 18F-FDG.ConclusionIn结论，心电门控DISA SPECT提供的信息，心肌活力，以及全球和区域LV功能，类似于PET和MRI获得的。
PurposeDual-isotope simultaneous acquisition single-photon emission computed tomography (DISA SPECT) with18F-fluorodeoxyglucose (FDG) and99mTc-sestamibi appears attractive for the detection of viable myocardium because it permits simultaneous assessment of glucose utilisation and perfusion. Another potential benefit of this approach is that the measurement of left ventricular (LV) function may be possible by ECG gating. The aim of this study was to test the hypothesis that both myocardial viability and LV function can be assessed by a single ECG-gated18F-FDG/99mTc-sestamibi DISA SPECT study, based on comparison with18F-FDG/13N-ammonia positron emission tomography (PET) and magnetic resonance imaging (MRI) as reference techniques.MethodsThirty-three patients with prior myocardial infarction underwent ECG-gated18F-FDG/99mTc-sestamibi DISA SPECT and18F-FDG/13N-ammonia PET on a single day. Of these, 25 patients also underwent cine-MRI to assess LV function. The LV myocardium was divided into nine regions, and each region was classified as viable or scar using a semiquantitative visual scoring system as well as quantitative analysis. The global and regional LV function measured by gated SPECT was compared with the results of MRI.ResultsThere was good agreement in respect of viability (90–96%,κ0.74–0.85) between DISA SPECT and PET by either visual or quantitative analysis. Furthermore, although both global and regional LV function measured by gated SPECT agreed with those by MRI,99mTc-sestamibi showed a closer correlation with MRI than did18F-FDG.ConclusionIn conclusion, ECG-gated DISA SPECT provides information on myocardial viability, as well as global and regional LV function, similar to that obtained by PET and MRI.