COMPARISON OF CARBON-11-ACETATE WITH FLUORINE-18-FLUORODEOXYGLUCOSE FOR DELINEATING VIABLE MYOCARDIUM BY POSITRON EMISSION TOMOGRAPHY
COMPARISON OF CARBON-11-ACETATE WITH FLUORINE-18-FLUORODEOXYGLUCOSE FOR DELINEATING VIABLE MYOCARDIUM BY POSITRON EMISSION TOMOGRAPHY
复制标题
DOI：
10.1016/0735-1097(93)90582-l
复制
发表时间：
1993-11-15
影响因子：
24
通讯作者：
SIEGEL, BA
中科院分区：
文献类型：
--
作者：
GROPLER, RJ;GELTMAN, EM;SIEGEL, BA
目标。本研究旨在确定对于晚期冠心病患者，使用碳 11 (C-11)-乙酸盐的正电子发射断层扫描 (PET) 是否可以比使用氟 18 (F-18)-氟脱氧葡萄糖的 PET 更有效地预测冠状动脉血运重建后机械功能的恢复。 背景。先前的研究结果表明，保存心肌氧化代谢（通过 PET 用 C-11-乙酸盐测量）对于冠状动脉血运重建后收缩功能的恢复是必要的。方法。通过分析 C-11-乙酸盐的心肌清除率，对 34 名患者进行血运重建前的心肌氧化代谢进行量化。通过分析 F-18-氟脱氧葡萄糖的摄取来评估葡萄糖的代谢。用于预测功能恢复的接受者操作特征曲线是针对氧化代谢和葡萄糖代谢的测量得出的。此外，还制定并比较了基于氧化代谢和葡萄糖代谢测量的功能恢复预测标准。结果。接受者操作特征曲线的分析表明，氧化代谢的估计在预测功能恢复方面比葡萄糖代谢的估计更可靠（p < 0.02）。此外，C-11-乙酸盐的阈值标准比 F-18 的标准表现出更高的阳性和阴性预测值（分别为 67% 和 89%）。氟脱氧葡萄糖（分别为 52% 和 81%），p < 0.01。在最初具有严重功能障碍的部分中，在预测功能恢复方面，氧化代谢的估计往往比葡萄糖代谢的估计更稳健。此外，在这些细分市场中，C-11 乙酸盐的阈值标准往往比 F-18-氟脱氧葡萄糖的标准（分别为 72% 和 82%）表现出更高的阳性和阴性预测值（分别为 85% 和 87%），尽管未达到统计学显着性。结论。对于患有晚期冠状动脉疾病的患者，通过使用 C-11-乙酸盐进行 PET 定量局部氧化代谢，可以准确地描述冠状动脉血运重建后功能恢复的程度。
Objectives. This study was designed to determine in patients with advanced coronary disease whether prediction of recovery of mechanical function after coronary revascularization could be accomplished more effectively by positron emission tomography (PET) with carbon 11 (C-11)-acetate than by PET with fluorine-18 (F-18)-fluorodeoxyglucose.Background. Results of previous studies have demonstrated that preservation of myocardial oxidative metabolism (measured by PET with C-11-acetate) is necessary for recovery of systolic function after coronary revascularization.Methods. Myocardial oxidative metabolism was quantified before revascularization in 34 patients by the analysis of the rate of myocardial clearance of C-11-acetate. Metabolism of glucose was assessed by analysis of uptake of F-18-fluorodeoxyglucose. Receiver operating characteristic curves for predicting functional recovery were derived for the measurements of oxidative metabolism and glucose metabolism. In addition, criteria for prediction of recovery of function based on measurements of oxidative metabolism and glucose metabolism were developed and compared.Results. Analysis of receiver operating characteristic curves indicated that estimates of oxidative metabolism were more robust in predicting functional recovery than were estimates of glucose metabolism (p < 0.02). Moreover, threshold criteria with C-11-acetate exhibited superior positive and negative predictive values (67% and 89%, respectively) than did the criteria with F-18. fluorodeoxyglucose (52% and 81%, respectively), p < 0.01. In segments with initially severe dysfunction, estimates of oxidative metabolism tended to be more robust than estimates of glucose metabolism in predicting functional recovery. Moreover, in such segments, the threshold criteria with C-11 acetate tended to exhibit superior positive and negative predictive values (85% and 87%, respectively) than did the criteria with F-18-fluorodeoxyglucose (72% and 82%, respectively), although statistical significance was not achieved.Conclusions. In patients with advanced coronary artery disease, the extent to which functional recovery can be anticipated after coronary revascularization can be delineated accurately by quantification of regional oxidative metabolism by PET with C-11-acetate.