Myocardial <sup>18</sup>F-FDG Uptake After Exercise-Induced Myocardial Ischemia in Patients with Coronary Artery Disease

Dou, Kefei; Yang, Min-Fu; Yang, Yue-Jin; Jain, Diwakar; He, Zuo-Xiang

doi:10.2967/jnumed.108.052936

Cited by 56 publications

(34 citation statements)

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“…[ [256,[266][267][268]. In line with the increased glucose metabolism, histochemical studies have shown that persistent myocardial ischemia increases GLUT1 expression in both ischemic and non-ischemic regions of the heart [269].…”

Section: Introductionmentioning

confidence: 84%

Roles of facilitative glucose transporter GLUT1 in [18F]FDG positron emission tomography (PET) imaging of human diseases

Patching¹

2015

J Diagn Imaging Ther

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The facilitative glucose transport protein GLUT1 has important roles in positron emission tomography (PET) imaging of human diseases. GLUT1 has widespread expression and catalyses the energyindependent facilitated diffusion of glucose down its concentration gradient across red blood cell membranes, blood-brain and blood-tissue barriers and membranes of some oragnelles. Import is usually the prevailing direction of transport for providing metabolic fuel, especially in proliferating cells. PET imaging using 2-deoxy-2-[ 18

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Section: Introductionmentioning

confidence: 84%

Roles of facilitative glucose transporter GLUT1 in [18F]FDG positron emission tomography (PET) imaging of human diseases

Patching¹

2015

J Diagn Imaging Ther

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“…In the clinical studies by He et al, exercise 18 F-FDG showed greater extent of myocardial ischemia compared to reversible perfusion abnormalities on exercise-rest 99m Tc-sestamibi imaging. [6][7][8] Whether exercise-rest 18 F-BMS747158-02 would provide information closer to that with exercise 18 F-FDG than exercise-rest SPECT perfusion imaging is difficult to speculate at this stage. Nevertheless, 18 F-BMS747158-02 appears to be a very promising new myocardial perfusion tracer, which warrants further clinical evaluation.…”

Section: See Related Article Pp 763-768mentioning

confidence: 99%

“…This is consistent with our clinical studies, where 18 F-FDG uptake following its injection at peak exercise in patients with coronary artery disease fasted for C12 hours was seen only in ischemic myocardium. [6][7][8] Yu et al studied only resting myocardial uptake of 18 F-BMS-747158-02 and 18 F-FDG in normal rats under different physiological studies. It would have been very helpful had the authors also included a parallel group of animals, who were given a catecholamine agent under fasting or fed conditions just before the administration of 18 F-BMS747158-02 or 18 F-FDG to mimic the effect of exercise to determine the differences between 18 F-BMS747158-02 and 18 F-FDG myocardial uptake at rest and on pharmacological stress.…”

Section: See Related Article Pp 763-768mentioning

confidence: 99%

“…Our group has recently shown that 18 F-FDG injected at peak exercise under fasting conditions is taken up selectively by the ischemic myocardium and this can be used as a hot spot imaging agent for the detection of CAD in clinical practice. [5][6][7][8] Under fasting conditions (particularly after fasting for over 12 hours), normal myocardium has very little myocardial 18 F-FDG uptake due to low blood sugar and insulin levels. However, myocardial ischemia results in a profound increase in regional glucose and 18 F-FDG uptake, which is not dependent upon blood glucose and insulin levels.…”

Section: See Related Article Pp 763-768mentioning

confidence: 99%

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Developing a new PET myocardial perfusion tracer

Jain

Ghanbarinia

2009

Journal of Nuclear Cardiology

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See related article, pp. 763-768Myocardial perfusion imaging is the most commonly used procedure in nuclear medicine. 1 Availability of thallium-201 made it possible to study myocardial perfusion non-invasively at rest and with exercise in mid70s. 2 Development of Tc-99m based perfusion tracers ( 99m Tc-sestamibi and 99m Tc-ttrofosminin) in early 90s overcame many of the limitations of Tl-201 and is largely responsible for MPI becoming the centerpiece of non-invasive techniques for the evaluation of coronary artery disease. 3 Despite the widespread use of 99m Tc labeled myocardial perfusion tracers, artifacts due to attenuation and extra-cardiac activity continue to be important limitations of these agents. Furthermore, these agents do not provide quantitative information about myocardial blood flow. Therefore, the search for an ideal perfusion tracer is still on. Positron emission tomography (PET) offers several advantages over single photon emission computed tomography (SPECT): better imaging characteristics due to higher photon flux, more robust attenuation correction, shorter image acquisition time and possibility of obtaining quantitative information about myocardial perfusion. It is thought PET imaging may be able to overcome the limitations of currently used SPECT perfusion tracers. Whereas a number of PET tracers are currently available for myocardial perfusion imaging, they all suffer from significant limitations:13 N-ammonia and 15 O-water require on-site cyclotron for their production, 82 Rb is generator produced, but given an extremely short half-life this can only be used with pharmacological stress. Therefore, attention is turning toward developing ligands, which can be labeled with generator produced PET radionuclides, or with cyclotron-produced radionuclides with relatively longer halflife, which do not necessarily require on-site cyclotrons. In this respect, gallium-68 and copper-64 are potentially attractive PET tracers, which can be eluted from generators with long shelf life. However, so far no suitable ligands have been developed to exploit the use of 68 Ga and 64 Cu as myocardial perfusion tracers. Interestingly, Yu and colleagues have presented preliminary experimental data in this issue of the journal on BMS-747158-02, a pyridazinone analog, which can be labeled with F-18 and used as a myocardial perfusion tracer. 4 Any new potential myocardial perfusion imaging agent has to undergo a series of elaborate studies to characterize its biokinetics and behavior in in vitro and in vivo studies to detect any possible interaction with a multitude of physiological and pharmacological variables. Myocardial uptake of an ideal myocardial perfusion tracer should correlate directly and linearly with myocardial blood flow over a wide range and should not be affected by other metabolic and physiological variables.Yu and colleagues studied myocardial and other organ uptake of 18 F-BMS747158-02 under fasting and non-fasting conditions and with the use of two different anesthetic agents (pentobarbital and k...

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“…Because we occasionally encounter patients who have undergone treadmill stress testing and myocardial perfusion imaging (MPI) within hours before PET, we decided to quantify the effect of exercise on 18 F-FDG muscle uptake and PET image quality. We also correlated cardiac 18 F-FDG uptake with perfusion defects on MPI because some investigators suggested that it may reflect myocardial ischemia (13,14).…”

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confidence: 99%

Treadmill Exercise Inducing Mild to Moderate Ischemia Has No Significant Effect on Skeletal Muscle or Cardiac ¹⁸F-FDG Uptake and Image Quality on Subsequent Whole-Body PET Scan

Lyall

Capobianco²,

Strausś³

et al. 2012

J Nucl Med

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We report the effects of treadmill exercise on 18 F-FDG uptake in skeletal muscles and image quality of torso PET and compare stress myocardial perfusion imaging patterns with myocardial 18 F-FDG uptake. There were 3 groups of patients: 48 patients underwent PET within 8 h after a treadmill test (Ex 8), 45 patients within 48 h after a treadmill test (Ex 48), and 34 patients without prior exercise. Mean workload (8.4 6 2.3 [Ex 8] vs. 8.9 6 2.6 metabolic equivalents [Ex 48]) was similar in both exercise groups. Muscle uptake was assessed by standardized uptake value. Myocardial uptake patterns were compared visually. Minor differences between patient groups were noted only for maximum standardized uptake value in quadriceps muscles. There was no correlation between perfusion defects and myocardial 18 F-FDG uptake patterns. Thus, treadmill exercise does not affect muscle 18 F-FDG uptake or image quality on subsequent PET. Cardiac 18 F-FDG uptake on torso PET scans is unrelated to myocardial perfusion status.

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Myocardial ¹⁸F-FDG Uptake After Exercise-Induced Myocardial Ischemia in Patients with Coronary Artery Disease

Cited by 56 publications

References 15 publications

Roles of facilitative glucose transporter GLUT1 in [18F]FDG positron emission tomography (PET) imaging of human diseases

Roles of facilitative glucose transporter GLUT1 in [18F]FDG positron emission tomography (PET) imaging of human diseases

Developing a new PET myocardial perfusion tracer

Treadmill Exercise Inducing Mild to Moderate Ischemia Has No Significant Effect on Skeletal Muscle or Cardiac ¹⁸F-FDG Uptake and Image Quality on Subsequent Whole-Body PET Scan

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Myocardial 18F-FDG Uptake After Exercise-Induced Myocardial Ischemia in Patients with Coronary Artery Disease

Cited by 56 publications

References 15 publications

Roles of facilitative glucose transporter GLUT1 in [18F]FDG positron emission tomography (PET) imaging of human diseases

Roles of facilitative glucose transporter GLUT1 in [18F]FDG positron emission tomography (PET) imaging of human diseases

Developing a new PET myocardial perfusion tracer

Treadmill Exercise Inducing Mild to Moderate Ischemia Has No Significant Effect on Skeletal Muscle or Cardiac 18F-FDG Uptake and Image Quality on Subsequent Whole-Body PET Scan

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Myocardial ¹⁸F-FDG Uptake After Exercise-Induced Myocardial Ischemia in Patients with Coronary Artery Disease

Treadmill Exercise Inducing Mild to Moderate Ischemia Has No Significant Effect on Skeletal Muscle or Cardiac ¹⁸F-FDG Uptake and Image Quality on Subsequent Whole-Body PET Scan