Document Detail


Myocardial rubidium-82 tissue kinetics assessed by dynamic positron emission tomography as a marker of myocardial cell membrane integrity and viability.
MedLine Citation:
PMID:  8548894     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recent reports have demonstrated the clinical use of rubidium-82 chloride (Rb-82) in combination with positron emission tomography (PET) not only as a tracer of myocardial blood flow but also as a marker of cell membrane integrity using static imaging early and late after tracer injection. The purpose of this study was to compare myocardial Rb-82 kinetics assessed by dynamic PET imaging as a marker for tissue viability with regional fluorine-18 fluorodeoxyglucose (FDG) uptake in patients with coronary artery disease. METHODS AND RESULTS: Twenty-seven patients with angiographically proven coronary artery disease and 5 subjects with a low likelihood for coronary artery disease underwent dynamic PET imaging under resting conditions using Rb-82 and FDG. Both image sequences served as input data for a semiautomated regional analysis program. This program generated polar maps representing Rb-82 tissue half-life and FDG utilization assessed by Patlak's approach. Myocardial tissue viability was visually determined from static Rb-82 and FDG images. Regions were categorized as normal, ischemically compromised, and scar tissue. Their coordinates were subsequently copied to the functional polar maps for further analyses. In normal subjects, Rb-82 tissue half-life was homogeneous throughout the left ventricle (90 +/- 11 seconds). In coronary patients, differences between Rb-82 tissue half-lives in normal and scar tissue were highly significant (95 +/- 10 and 57 +/- 15 seconds, respectively; P < .0001). FDG uptake in these two tissue groups was 78 +/- 12% and 40 +/- 13%, respectively (P < .0001). Ischemically compromised tissue with reduced perfusion but maintained FDG uptake displayed an Rb-82 half-life of 75 +/- 9 seconds, indicating active cellular tracer retention, which was significantly different from scar tissue. Overall agreement of tissue categorization as either viable or scar was 86% between Rb-82 kinetics and FDG utilization. In a subgroup of 11 patients with all three tissue types within one image set, Rb-82 tissue half-life discriminated between normal, ischemic, and scar tissue (97 +/- 9, 75 +/- 9, and 60 +/- 15 seconds, respectively; P < .01). CONCLUSIONS: This study demonstrated a significant relationship between cell membrane integrity as assessed by dynamic Rb-82 PET imaging and myocardial glucose utilization as a marker for tissue viability. In regions with reduced perfusion, Rb-82 kinetics was different in compromised but metabolically active and irreversibly injured myocardium. The predictive value of this approach must be evaluated in follow-up studies.
Authors:
J vom Dahl; O Muzik; E R Wolfe; C Allman; G Hutchins; M Schwaiger
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  93     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1996 Jan 
Date Detail:
Created Date:  1996-02-20     Completed Date:  1996-02-20     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  238-45     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, University of Michigan, Ann Arbor, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cell Membrane / metabolism
Deoxyglucose / analogs & derivatives,  metabolism
Female
Fluorodeoxyglucose F18
Half-Life
Humans
Male
Middle Aged
Myocardium / metabolism*
Rubidium Radioisotopes / diagnostic use*
Tomography, Emission-Computed*
Grant Support
ID/Acronym/Agency:
R01-HL-41047-01/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Rubidium Radioisotopes; 154-17-6/Deoxyglucose; 63503-12-8/Fluorodeoxyglucose F18

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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