Abstract:
:Prospective delineation of viable from nonviable myocardium in patients with coronary artery disease in an important factor in deciding whether a patient should be revascularized or treated medically. Two common techniques--single-photon emission computed tomography (SPECT) and positron-emission computed tomography (PET)--are used in nuclear medicine using various radiopharmaceuticals for the detection of myocardial viability in patients. Thallium-201 (201Tl) and technetium-99m (99mTc)-sestamibi are the common radiopharmaceuticals used in different protocols using SPECT, whereas fluoride-18 (18F)-fluorodeoxyglucose (FDG) and rubidium-82 (82Rb) are most widely used in PET. The SPECT protocols involve stress/redistribution, stress/redistribution/reinjection, and rest/redistribution imaging techniques. Many studies have compared the results of 201Tl and (99mTc)-sestamibi SPECT with those of FDG PET; in some studies, concordant results have been found between delayed thallium and FDG results, indicating that 201Tl, although considered a perfusion agent, shows myocardial viability. Discordant results in a number of studies have been found between sestamibi and FDG, suggesting that the efficacy of sestamibi as a viability marker has yet to be established. Radiolabeled fatty acids such as iodine-123 (123I)-para-iodophenylpentadecanoic acid and carbon-11 (11C)-palmitic acid have been used for the assessment of myocardial viability with limited success. 11C-labeled acetate is a good marker of oxidative metabolism in the heart and has been used to predict the reversibility of wall motion abnormalities. (18F)-FDG is considered the marker of choice for myocardial viability, although variable results are obtained under different physiological conditions. Detection of myocardial viability can be greatly improved by developing new equipment and radiopharmaceuticals of better quality.
journal_name
Semin Nucl Medjournal_title
Seminars in nuclear medicineauthors
Saha GB,MacIntyre WJ,Brunken RC,Go RT,Raja S,Wong CO,Chen EQdoi
10.1016/s0001-2998(96)80007-9subject
Has Abstractpub_date
1996-10-01 00:00:00pages
315-35issue
4eissn
0001-2998issn
1558-4623pii
S0001-2998(96)80007-9journal_volume
26pub_type
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journal_title:Seminars in nuclear medicine
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journal_title:Seminars in nuclear medicine
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journal_title:Seminars in nuclear medicine
pub_type: 杂志文章,评审
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更新日期:1995-04-01 00:00:00
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journal_title:Seminars in nuclear medicine
pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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journal_title:Seminars in nuclear medicine
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journal_title:Seminars in nuclear medicine
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