Stoll H P, Hellwig N, Alexander C, Ozbek C, Schieffer H, Oberhausen E
Medizinische Universitätsklinik und Poliklinik, Universität des Saarlandes, Homburg/Saar, Germany.
Eur J Nucl Med. 1994 Oct;21(10):1085-93. doi: 10.1007/BF00181063.
The detection of preserved glucose uptake in hypoperfused dysfunctional myocardium by fluorine-18 deoxyglucose (FDG) positron emission tomography (PET) represents the method of choice in myocardial viability diagnostics. As the technique is not available for the majority of patients due to cost and the limited capacity of the PET centres, it was the aim of the present work to develop and test FDG single-photon emission tomography (SPET) with the means of conventional nuclear medicine. The perfusion marker sestamibi (MIBI) was used together with the metabolic tracer FDG in dual-isotope acquisition. A conventional SPET camera was equipped with a 511-keV collimator and designed to operate with simultaneous four-channel acquisition. In this way, the scatter of 18F into the technetium-99m energy window could be taken into account by a novel method of scatter correction. Thirty patients with regional wall motion abnormalities at rest were investigated. The results of visual wall motion analysis by contrast cine-ventriculography in nine segments/heart were compared with the results of quantitative scintigraphy. The scintigraphic patterns of MIBI and FDG tracer accumulation were defined as normal, matched defects and perfusion-metabolism mismatches. Spatial resolution of the system was satisfactory, with a full width at half maximum (FWHM) of 15.2 mm for 18F and 14.0 mm for 99mTc, as measured by planar imaging in air at 5 cm distance from the collimator. Image quality allowed interpretation in all 30 patients. 88% of segments without relevant wall motion abnormalities presented normal scintigraphic results. Seventy-five akinetic segments showed mismatches in 27%, matched defects in 44% and normal perfusion in 29%. We conclude that FDG-MIBI dual-isotope SPET is technically feasible with the means of conventional nuclear medicine. Thus, the method is potentially available for widespread application in patient care and may represent an alternative to the 201Tl reinjection technique.
通过氟 - 18脱氧葡萄糖（FDG）正电子发射断层扫描（PET）检测灌注不足的功能失调心肌中保留的葡萄糖摄取，是心肌存活诊断的首选方法。由于成本以及PET中心容量有限，大多数患者无法使用该技术，因此本研究的目的是利用传统核医学手段开发并测试FDG单光子发射断层扫描（SPET）。在双同位素采集过程中，灌注标记物司他比（MIBI）与代谢示踪剂FDG一起使用。一台传统的SPET相机配备了511 keV准直器，并设计为可同时进行四通道采集。通过这种方式，可采用一种新型散射校正方法来考虑18F散射到锝 - 99m能量窗内的情况。对30例静息时出现局部室壁运动异常的患者进行了研究。将通过对比电影心室造影对九个节段/心脏进行的视觉室壁运动分析结果与定量闪烁扫描结果进行了比较。MIBI和FDG示踪剂积聚的闪烁扫描模式被定义为正常、匹配缺损和灌注 - 代谢不匹配。通过在距准直器5 cm的空气中进行平面成像测量，系统的空间分辨率令人满意，18F的半高宽（FWHM）为15.2 mm，99mTc为14.0 mm。图像质量使所有30例患者的结果均可进行解读。88%没有相关室壁运动异常的节段闪烁扫描结果正常。75个运动减弱节段中，27%表现为不匹配，44%为匹配缺损，29%为灌注正常。我们得出结论，FDG - MIBI双同位素SPET在传统核医学手段下技术上是可行的。因此，该方法有可能广泛应用于患者护理，并且可能是铊 - 201再注射技术的一种替代方法。
