Combined study with I-123 fatty acid and thallium-201 to assess ischemic myocardium: comparison with thallium redistribution and glucose metabolism

To assess the clinical value of combined SPECT imaging with I-123-15-(p-iodophenyl)-3-methyl pentadecanoic acid (BMIPP) and thallium-201 (Tl), the findings were compared with those obtained in a stress Tl study and positron emission tomography (PET) with fluorine-18-fluorodeoxyglucose (FDG) in 22 pa...

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Bibliographic Details
Published in:Annals of nuclear medicine 1994-03, Vol.8 (1), p.47-54
Main Authors: Kawamoto, M, Tamaki, N, Yonekura, Y, Tadamura, E, Fujibayashi, Y, Magata, Y, Nohara, R, Sasayama, S, Ikekubo, K, Kato, H
Format: Article
Language:English
Subjects:
Adult
Aged
Deoxyglucose - analogs & derivatives
Deoxyglucose - pharmacokinetics
Exercise Test
Fatty Acids
Female
Fluorodeoxyglucose F18
Glucose - metabolism
Humans
Iodobenzenes - pharmacokinetics
Male
Middle Aged
Myocardial Ischemia - diagnostic imaging
Myocardial Ischemia - metabolism
Thallium Radioisotopes - pharmacokinetics
Tomography, Emission-Computed
Tomography, Emission-Computed, Single-Photon
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Summary:To assess the clinical value of combined SPECT imaging with I-123-15-(p-iodophenyl)-3-methyl pentadecanoic acid (BMIPP) and thallium-201 (Tl), the findings were compared with those obtained in a stress Tl study and positron emission tomography (PET) with fluorine-18-fluorodeoxyglucose (FDG) in 22 patients with myocardial infarction. In 20 patients who underwent a stress Tl study, among 75 hypoperfused segments, 27 segments exhibited less BMIPP uptake than Tl (discordant segments), and the remaining 48 segments showed a similar decrease in BMIPP uptake (concordant segments). Twenty-two of 27 discordant segments (81%) exhibited redistribution on stress Tl study. On the other hand, only one of the 48 concordant segments had redistribution (p < 0.001). In 10 patients who underwent a FDG PET study, among 33 hypoperfused segments, seven segments were discordant segments, and the remaining 25 segments were concordant segments. Seven of the eight discordant segments (88%) demonstrated an increase in FDG uptake. In contrast, only five of 25 concordant segments (20%) showed increase in FDG uptake (p < 0.01). Thus, the segments showing discordant BMIPP uptake are considered to be ischemic but viable myocardium. We conclude that combined imaging with BMIPP and Tl is a useful mean for evaluating tissue viability in patients with coronary artery disease, but it may underestimate the extent of tissue viability, compared with FDG PET imaging.
ISSN:0914-7187
1864-6433
DOI:10.1007/BF03164986