Myocardial viability: Fluorine-18-deoxyglucose positron emission tomography in prediction of wall motion recovery after revascularization
To assess the value of positron emission tomography (PET) imaging with fluorine-18-deoxyglucose ([ 18F]FDG) in predicting cardiac wall motion recovery after revascularization, 48 consecutive patients with previous myocardial infarction were studied. The normalized [ 18F]FDG uptake at rest was assess...
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| Veröffentlicht in: | The American heart journal 1994-04, Vol.127 (4), p.785-796 |
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| container_title | The American heart journal |
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| creator | Knuuti, M.Juhani Saraste, Markku Nuutila, Pirjo Härkönen, Risto Wegehus, Uno Haapanen, Arto Bergman, Jörgen Haaparanta, Merja Savunen, Timo Voipio-Pulkki, Liisa-Maria |
| description | To assess the value of positron emission tomography (PET) imaging with fluorine-18-deoxyglucose ([
18F]FDG) in predicting cardiac wall motion recovery after revascularization, 48 consecutive patients with previous myocardial infarction were studied. The normalized [
18F]FDG uptake at rest was assessed semiquantitatively and compared to perfusion at rest as studied by SPECT imaging. Wall motion was analyzed with echocardiography before and after revascularization. Wall motion recovery occurred in 27 (30%) of the revascularized 90 dysfunctional segments. Preserved [
18F]FDG uptake (mean ± 2 SD) was commonly found in dysfunctional segments, but only 54% of these segments recovered after revascularization. Subnormal [
18F]FDG uptake identified accurately the segments with no potential to recover (predictive value 100%). By using an optimized threshold value for normalized [
18F]FDG uptake, the sensitivity of 85% and specificity of 84% to predict functional recovery were reached simultaneously. However, in the segments with moderately or severely reduced perfusion at rest, the diagnostic accuracy of [
18F]FDG uptake for viability was 100%. The results of this study show that the presence of viable tissue indicated by preserved [
18F]FDG uptake does not inevitably imply functional recovery after revascularization. However, acceptable diagnostic accuracy for viability might be reached by [
18F]FDG alone, providing that appropriate uptake limits are used. The combined evaluation of [
18F]FDG uptake and perfusion enables precise assessment of myocardial viability. |
| doi_str_mv | 10.1016/0002-8703(94)90545-2 |
| format | Article |
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18F]FDG) in predicting cardiac wall motion recovery after revascularization, 48 consecutive patients with previous myocardial infarction were studied. The normalized [
18F]FDG uptake at rest was assessed semiquantitatively and compared to perfusion at rest as studied by SPECT imaging. Wall motion was analyzed with echocardiography before and after revascularization. Wall motion recovery occurred in 27 (30%) of the revascularized 90 dysfunctional segments. Preserved [
18F]FDG uptake (mean ± 2 SD) was commonly found in dysfunctional segments, but only 54% of these segments recovered after revascularization. Subnormal [
18F]FDG uptake identified accurately the segments with no potential to recover (predictive value 100%). By using an optimized threshold value for normalized [
18F]FDG uptake, the sensitivity of 85% and specificity of 84% to predict functional recovery were reached simultaneously. However, in the segments with moderately or severely reduced perfusion at rest, the diagnostic accuracy of [
18F]FDG uptake for viability was 100%. The results of this study show that the presence of viable tissue indicated by preserved [
18F]FDG uptake does not inevitably imply functional recovery after revascularization. However, acceptable diagnostic accuracy for viability might be reached by [
18F]FDG alone, providing that appropriate uptake limits are used. The combined evaluation of [
18F]FDG uptake and perfusion enables precise assessment of myocardial viability.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/0002-8703(94)90545-2</identifier><identifier>PMID: 8154416</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Angioplasty, Balloon, Coronary ; Biological and medical sciences ; Cardiology. Vascular system ; Coronary Artery Bypass ; Coronary heart disease ; Deoxyglucose - analogs & derivatives ; Deoxyglucose - pharmacokinetics ; Female ; Fluorine Radioisotopes - pharmacokinetics ; Fluorodeoxyglucose F18 ; Heart ; Heart - diagnostic imaging ; Humans ; Male ; Medical sciences ; Middle Aged ; Myocardial Contraction ; Myocardial Infarction - diagnostic imaging ; Myocardial Infarction - therapy ; Myocardium - metabolism ; Postoperative Period ; Predictive Value of Tests ; Sensitivity and Specificity ; Tomography, Emission-Computed ; Tomography, Emission-Computed, Single-Photon ; Ultrasonography</subject><ispartof>The American heart journal, 1994-04, Vol.127 (4), p.785-796</ispartof><rights>1994</rights><rights>1994 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c386t-f9abfa645ce5eb7f5efb48584138508ae1a5361394d4347665eed6018c6b3b0c3</citedby><cites>FETCH-LOGICAL-c386t-f9abfa645ce5eb7f5efb48584138508ae1a5361394d4347665eed6018c6b3b0c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0002-8703(94)90545-2$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,782,786,3552,27931,27932,46002,64394</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4056791$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8154416$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Knuuti, M.Juhani</creatorcontrib><creatorcontrib>Saraste, Markku</creatorcontrib><creatorcontrib>Nuutila, Pirjo</creatorcontrib><creatorcontrib>Härkönen, Risto</creatorcontrib><creatorcontrib>Wegehus, Uno</creatorcontrib><creatorcontrib>Haapanen, Arto</creatorcontrib><creatorcontrib>Bergman, Jörgen</creatorcontrib><creatorcontrib>Haaparanta, Merja</creatorcontrib><creatorcontrib>Savunen, Timo</creatorcontrib><creatorcontrib>Voipio-Pulkki, Liisa-Maria</creatorcontrib><title>Myocardial viability: Fluorine-18-deoxyglucose positron emission tomography in prediction of wall motion recovery after revascularization</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>To assess the value of positron emission tomography (PET) imaging with fluorine-18-deoxyglucose ([
18F]FDG) in predicting cardiac wall motion recovery after revascularization, 48 consecutive patients with previous myocardial infarction were studied. The normalized [
18F]FDG uptake at rest was assessed semiquantitatively and compared to perfusion at rest as studied by SPECT imaging. Wall motion was analyzed with echocardiography before and after revascularization. Wall motion recovery occurred in 27 (30%) of the revascularized 90 dysfunctional segments. Preserved [
18F]FDG uptake (mean ± 2 SD) was commonly found in dysfunctional segments, but only 54% of these segments recovered after revascularization. Subnormal [
18F]FDG uptake identified accurately the segments with no potential to recover (predictive value 100%). By using an optimized threshold value for normalized [
18F]FDG uptake, the sensitivity of 85% and specificity of 84% to predict functional recovery were reached simultaneously. However, in the segments with moderately or severely reduced perfusion at rest, the diagnostic accuracy of [
18F]FDG uptake for viability was 100%. The results of this study show that the presence of viable tissue indicated by preserved [
18F]FDG uptake does not inevitably imply functional recovery after revascularization. However, acceptable diagnostic accuracy for viability might be reached by [
18F]FDG alone, providing that appropriate uptake limits are used. The combined evaluation of [
18F]FDG uptake and perfusion enables precise assessment of myocardial viability.</description><subject>Angioplasty, Balloon, Coronary</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Coronary Artery Bypass</subject><subject>Coronary heart disease</subject><subject>Deoxyglucose - analogs & derivatives</subject><subject>Deoxyglucose - pharmacokinetics</subject><subject>Female</subject><subject>Fluorine Radioisotopes - pharmacokinetics</subject><subject>Fluorodeoxyglucose F18</subject><subject>Heart</subject><subject>Heart - diagnostic imaging</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Contraction</subject><subject>Myocardial Infarction - diagnostic imaging</subject><subject>Myocardial Infarction - therapy</subject><subject>Myocardium - metabolism</subject><subject>Postoperative Period</subject><subject>Predictive Value of Tests</subject><subject>Sensitivity and Specificity</subject><subject>Tomography, Emission-Computed</subject><subject>Tomography, Emission-Computed, Single-Photon</subject><subject>Ultrasonography</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFu1DAQhi0EKtvCG4DkA0LlELAT27F7QEIVBaQiLnC2HGdcjJw42MlCeAPeGqe72iMn-9f_zWjmH4SeUfKaEireEELqSrakuVTslSKc8ap-gHaUqLYSLWMP0e6EPEbnOf8oUtRSnKEzSTljVOzQ389rtCb13gS896bzwc_rFb4JS0x-hIrKqof4e70Li40Z8BSzn1McMQw-Z18-cxziXTLT9xX7EU8Jem_nzYgO_zIh4CHeywQ27iGt2LgZUpF7k-0STPJ_zAY8QY-cCRmeHt8L9O3m_dfrj9Xtlw-frt_dVraRYq6cMp0zgnELHLrWcXAdk1wy2khOpAFqeCNoo1jPGtYKwQF6Qai0oms6YpsL9PLQd0rx5wJ51mUTCyGYEeKSdStYrXitCsgOoE0x5wROT8kPJq2aEr1dQG_x6i1erZi-v4CuS9nzY_-lG6A_FR0jL_6Lo1_2N8ElM1qfTxgjXLSKFuztAYOSxd5D0tl6GG2JtyQ56z76_8_xDwb7pao</recordid><startdate>19940401</startdate><enddate>19940401</enddate><creator>Knuuti, M.Juhani</creator><creator>Saraste, Markku</creator><creator>Nuutila, Pirjo</creator><creator>Härkönen, Risto</creator><creator>Wegehus, Uno</creator><creator>Haapanen, Arto</creator><creator>Bergman, Jörgen</creator><creator>Haaparanta, Merja</creator><creator>Savunen, Timo</creator><creator>Voipio-Pulkki, Liisa-Maria</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19940401</creationdate><title>Myocardial viability: Fluorine-18-deoxyglucose positron emission tomography in prediction of wall motion recovery after revascularization</title><author>Knuuti, M.Juhani ; Saraste, Markku ; Nuutila, Pirjo ; Härkönen, Risto ; Wegehus, Uno ; Haapanen, Arto ; Bergman, Jörgen ; Haaparanta, Merja ; Savunen, Timo ; Voipio-Pulkki, Liisa-Maria</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c386t-f9abfa645ce5eb7f5efb48584138508ae1a5361394d4347665eed6018c6b3b0c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Angioplasty, Balloon, Coronary</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Coronary Artery Bypass</topic><topic>Coronary heart disease</topic><topic>Deoxyglucose - analogs & derivatives</topic><topic>Deoxyglucose - pharmacokinetics</topic><topic>Female</topic><topic>Fluorine Radioisotopes - pharmacokinetics</topic><topic>Fluorodeoxyglucose F18</topic><topic>Heart</topic><topic>Heart - diagnostic imaging</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Contraction</topic><topic>Myocardial Infarction - diagnostic imaging</topic><topic>Myocardial Infarction - therapy</topic><topic>Myocardium - metabolism</topic><topic>Postoperative Period</topic><topic>Predictive Value of Tests</topic><topic>Sensitivity and Specificity</topic><topic>Tomography, Emission-Computed</topic><topic>Tomography, Emission-Computed, Single-Photon</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Knuuti, M.Juhani</creatorcontrib><creatorcontrib>Saraste, Markku</creatorcontrib><creatorcontrib>Nuutila, Pirjo</creatorcontrib><creatorcontrib>Härkönen, Risto</creatorcontrib><creatorcontrib>Wegehus, Uno</creatorcontrib><creatorcontrib>Haapanen, Arto</creatorcontrib><creatorcontrib>Bergman, Jörgen</creatorcontrib><creatorcontrib>Haaparanta, Merja</creatorcontrib><creatorcontrib>Savunen, Timo</creatorcontrib><creatorcontrib>Voipio-Pulkki, Liisa-Maria</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Knuuti, M.Juhani</au><au>Saraste, Markku</au><au>Nuutila, Pirjo</au><au>Härkönen, Risto</au><au>Wegehus, Uno</au><au>Haapanen, Arto</au><au>Bergman, Jörgen</au><au>Haaparanta, Merja</au><au>Savunen, Timo</au><au>Voipio-Pulkki, Liisa-Maria</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Myocardial viability: Fluorine-18-deoxyglucose positron emission tomography in prediction of wall motion recovery after revascularization</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>1994-04-01</date><risdate>1994</risdate><volume>127</volume><issue>4</issue><spage>785</spage><epage>796</epage><pages>785-796</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>To assess the value of positron emission tomography (PET) imaging with fluorine-18-deoxyglucose ([
18F]FDG) in predicting cardiac wall motion recovery after revascularization, 48 consecutive patients with previous myocardial infarction were studied. The normalized [
18F]FDG uptake at rest was assessed semiquantitatively and compared to perfusion at rest as studied by SPECT imaging. Wall motion was analyzed with echocardiography before and after revascularization. Wall motion recovery occurred in 27 (30%) of the revascularized 90 dysfunctional segments. Preserved [
18F]FDG uptake (mean ± 2 SD) was commonly found in dysfunctional segments, but only 54% of these segments recovered after revascularization. Subnormal [
18F]FDG uptake identified accurately the segments with no potential to recover (predictive value 100%). By using an optimized threshold value for normalized [
18F]FDG uptake, the sensitivity of 85% and specificity of 84% to predict functional recovery were reached simultaneously. However, in the segments with moderately or severely reduced perfusion at rest, the diagnostic accuracy of [
18F]FDG uptake for viability was 100%. The results of this study show that the presence of viable tissue indicated by preserved [
18F]FDG uptake does not inevitably imply functional recovery after revascularization. However, acceptable diagnostic accuracy for viability might be reached by [
18F]FDG alone, providing that appropriate uptake limits are used. The combined evaluation of [
18F]FDG uptake and perfusion enables precise assessment of myocardial viability.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>8154416</pmid><doi>10.1016/0002-8703(94)90545-2</doi><tpages>12</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | The American heart journal, 1994-04, Vol.127 (4), p.785-796 |
| issn | 0002-8703 1097-6744 |
| language | eng |
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| source | MEDLINE; Access via ScienceDirect (Elsevier); ProQuest Central UK/Ireland |
| subjects | Angioplasty, Balloon, Coronary Biological and medical sciences Cardiology. Vascular system Coronary Artery Bypass Coronary heart disease Deoxyglucose - analogs & derivatives Deoxyglucose - pharmacokinetics Female Fluorine Radioisotopes - pharmacokinetics Fluorodeoxyglucose F18 Heart Heart - diagnostic imaging Humans Male Medical sciences Middle Aged Myocardial Contraction Myocardial Infarction - diagnostic imaging Myocardial Infarction - therapy Myocardium - metabolism Postoperative Period Predictive Value of Tests Sensitivity and Specificity Tomography, Emission-Computed Tomography, Emission-Computed, Single-Photon Ultrasonography |
| title | Myocardial viability: Fluorine-18-deoxyglucose positron emission tomography in prediction of wall motion recovery after revascularization |
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