Myocardial viability assessment in 18FDG PET/CT study (18FDG PET myocardial viability assessment)

Abstract

Accurate identification of viable myocardium is crucial in patientqualification for medical or surgical treatment. Only personswith confirmed cardiac viability will benefit from revascularizationprocedures. It is also well known, that the amount of viablemyocardium assessed preoperatively is the best indicator oflong term cardiac event free survival after cardiac intervention.There are several diagnostic approaches used in current clinicalpractice for assessment of myocardial viability. Analysis ofwall thickness or myocardial contraction, evaluation of cardiacperfusion or metabolism can be assessed using followingmodalities: Echocardiography, Cardiac Molecular Imagingtechniques (PET, SPECT), Cardiovascular MR or CardiovascularCT. The article describes the methods and problems ofviability assessment in 18FDG PET study. PET imaging hasproved its accuracy and reproducibility for myocardial ischemiaand viability assessment. However this unique in its ability forshowing the particular substrate metabolism technique has unfortunately some disadvantages: currently achieved PETresolution is 0.4 cm. However the combined devices multislicecomputed tomography scanners with PET (PET/CT) are nowwidely used in clinical practice. This combination allows forwider morphologic assessments: coronary calcium scoring andnon-invasive coronary angiography may be added to myocardialperfusion/metabolic imaging if necessary.