320 likes | 1.79k Views
Myocardial Viability. Clinical– angina PET MRI Thallium Dobutamine Echo. Guludec DL, Eur J Nucl Med Mol Imaging (2008) 35:1709–1724. Cardiac Perfusion and Viability Study by PET/CT. 75 year old male Scan protocol: low dose CT for attenuation correction
E N D
Myocardial Viability • Clinical– angina • PET • MRI • Thallium • Dobutamine Echo Guludec DL, Eur J Nucl Med Mol Imaging (2008) 35:1709–1724
Cardiac Perfusion and Viability Study by PET/CT 75 year old male Scan protocol: low dose CT for attenuation correction PET 740 MBq NH3, 10 minute scan, 370 MBq FDG, 10 minute scan Data Courtesy of University of Michigan
Survival by Viability and Treatment 93 Patients with Ischemic Cardiomyopathy and severely depressed left ventricular function With PET Mismatch Without PET Mismatch 1.0 1.0 CABG CABG 0.8 0.8 0.6 0.6 Medical p = 0.007 Survival Probability Medical 0.4 0.4 0.2 0.2 NS 0.0 0.0 0 12 24 36 48 60 0 12 24 36 48 60 Time (months) Time (months) Di Carli et al, J Thor Cardiovasc Surg 1998; 116: 997
FDG IMAGING IN LV ANEURYSMS 70 pts with LV aneurysm 6.8 yrs FU Surgery for viability improved EF and survival (p .0001) Medical therapy with viability had worst outcome (p .0001) Zhang X et al J Nucl Med 2008; 49:1288–1298
Adjusted survival curves for PET and standard arms in Ottawa-FIVE substudy Abraham1 A, J Nucl Med 2010; 51:567–574
100 90 70 50 30 0 12 24 36 48 60 Nuclear Imaging Predicts Long-Term Outcome After CABG From Pagley et al. J Am Coll Cardiol 1996;27:299A. More ViabilityLess Viability % Event-free p=0.025 Time (Months)
Survival free of Death/MI in patients with and without viable myocardium on Nitrate-Augmented Tc-99m-MIBI SPECT Viable Non-Viable He ZX, et al, Am J Cardiol 2003 Yang MF, et al. Nucl Med Comm 200
Contrast MRI vs. DISA SPECT Liu Q, et al. Nucl Med Comm 2009