Tian M, Koyama K, Zhang H, Oriuchi N, Higuchi T, Endo K
Department of Nuclear Medicine and Diagnostic Radiology, Gunma University School of Medicine, Maebashi, Gunma, Japan.
Nucl Med Commun. 2003 Apr;24(4):367-74. doi: 10.1097/00006231-200304000-00005.
The use of dual-head gamma camera modified positron coincidence detection (PCD) is a new, alternative method of 2-[18F]fluoro-2-deoxy-D-glucose (FDG) imaging. This study investigated the potential ability of evaluating myocardial viability in patients with ischaemic heart disease by FDG imaging using PCD. A total of 21 patients (18 male, three female; mean age 59.7+/-8.5 years) with a history of previous myocardial infarction and confirmed coronary angiography underwent FDG PCD and FDG PET after oral glucose loading (75 g). Quantitative analysis was compared between images of FDG PCD and FDG PET. A significant linear correlation between the segmental percentage of FDG uptake obtained by PCD and PET was observed (r=0.63, P<0.001). By receiver operating characteristic (ROC) analysis, using FDG PET as the 'gold standard', at the 50% threshold value in PET, FDG PCD showed a sensitivity of 92% and specificity of 63% in detecting myocardial viability. Regional analysis showed lower agreement of FDG PCD and FDG PET in the inferior (79%) and septal (70%) walls compared with the other walls. Quantitative evaluation of myocardial viability using FDG PCD yielded comparable clinical results in apex, anterior and lateral walls to that of FDG PET. However, the agreement was lower in the inferior and septal walls. Therefore, results of FDG PCD should be carefully interpreted in evaluating myocardial viability in the inferior and septal walls. The application of a measured attenuation correction and scatter correction are needed to improve the detectability of myocardial viability in FDG imaging by coincidence gamma camera.
使用双头γ相机改良正电子符合探测（PCD）是一种新型的2-[18F]氟-2-脱氧-D-葡萄糖（FDG）成像替代方法。本研究通过使用PCD的FDG成像来探究评估缺血性心脏病患者心肌存活能力的潜在能力。共有21例有既往心肌梗死病史且冠状动脉造影确诊的患者（18例男性，3例女性；平均年龄59.7±8.5岁）在口服葡萄糖负荷（75 g）后接受了FDG PCD和FDG PET检查。对FDG PCD和FDG PET图像进行了定量分析比较。观察到PCD和PET获得的FDG摄取节段百分比之间存在显著的线性相关性（r = 0.63，P < 0.001）。通过受试者工作特征（ROC）分析，以FDG PET作为“金标准”，在PET的50%阈值时，FDG PCD在检测心肌存活方面显示出92%的敏感性和63%的特异性。区域分析显示，与其他壁相比，下壁（79%）和间隔壁（70%）的FDG PCD和FDG PET一致性较低。使用FDG PCD对心肌存活进行定量评估，在心尖、前壁和侧壁产生的临床结果与FDG PET相当。然而，下壁和间隔壁的一致性较低。因此，在评估下壁和间隔壁的心肌存活时，应谨慎解读FDG PCD的结果。需要应用测量的衰减校正和散射校正来提高符合γ相机在FDG成像中检测心肌存活的能力。
