HISTOMORPHOLOGIC VALIDATION OF THALLIUM AND 18FDG PET CRITERIA FOR VIABILITY

铊再注射和18F-氟脱氧葡萄糖（FDG）正电子 发射断层摄影（PET）协议已经显示出与 预测血运重建后机能不全区域的功能恢复。 虽然铊再注射和FDG PET之间的良好相关性， 令人鼓舞的是，没有定量的组织形态学“金标准”， 在人类受试者中验证铊的可行性信息， FDG 因此，我们前瞻性研究了15名非糖尿病、慢性 缺血性心肌病患者列出的心脏移植， 静息时应力再分布铊断层扫描和FDG PET。 8分 已接受心脏移植，其中6例 由2名经验丰富的病理学家进行组织形态学分析， 铊和PET结果。 将离体心脏沿短轴方向切开 切片（平均厚度7 mm）和来自 在用 天狼星红。 每个断层图像分为8个区域， 分别计算每个区域中活肌细胞的面积百分比。 对于铊再分布、再注射和FDG PET研究， 铊负荷图像系列上计数最多的心肌区域 被用作该患者的正常参考区域。 在48个 匹配的组织形态学，铊和FDG区域分析，而 再分布时的铊吸收百分比（平均值）与 71.5± 22.3）和活肌细胞%（通过组织形态学分析） (mean 74.9 ± 15.4，r= 0.56，小于0.001），相关系数为 用铊再注射改善（平均73.7 ± 23.7，r= 0.67， 001）和FDG PET（平均76.3 ± 19.4，r= 0.67，p <0.001）。 0.001）。 这些数据提供了组织形态学证实， 铊和FDG摄取量的大小正确估计分布 活的心肌细胞的数量

Both thallium reinjection and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) protocols have been shown to correlate and predict functional recovery of asynergic regions after revascularization. While such good correlation between thallium reinjection and FDG PET is encouraging, there is no quantitative, histomorphologic "gold standard" in human subjects that validate the viability information of thallium and FDG. Therefore, we prospectively studied 15 nondiabetic, chronic ischemic cardiomyopathy patients listed for cardiac transplantation, with stress-redistribution thallium tomography and FDG PET at rest. Eight pts have received cardiac transplantation, of whom 6 have had histomorphologic analysis by 2 experienced pathologist blinded to the thallium and PET results. The explanted hearts were sliced in short-axis sections (mean thickness 7 mm) and the volume fraction of myocytes from midventricular slices were studied quantitatively after staining with Picro Sirius red. Each tomogram was divided into 8 regions and the percent area of viable myocytes in each region was calculated separately. For thallium redistribution, reinjection, and FDG PET studies, the myocardial region with maximum counts on the thallium stress image series was used as the normal reference region for that patient. Among the 48 matched histomorphologic, thallium and FDG regions analyzed, while there was a good correlation between % thallium uptake on redistribution (mean 71.5 plus/minus 22.3) and % viable myocytes by histomorphologic analysis (mean 74.9 plus/minus 15.4, r=.56, pless than0.001), the correlation was improved with thallium reinjection (mean 73.7 + 23.7, r=.67, plessthan0.001) and FDG PET (mean 76.3 plus/minus 19.4, r=.67, p less than0.001). These data provide histomorphologic confirmation that the magnitude of thallium and FDG uptake correctly estimate the distribution of viable myocytes in human subjects.