Use of resting myocardial 18F-FDG imaging in the detection of unstable angina

Abstract

This pilot study demonstrated that resting 18F-FDG PET/CT imaging is an accurate and sensitive technique for the identification of UA.

Dual-time-point myocardial 18F-FDG imaging in the detection of coronary artery disease

“…Fifty-five patients with suspected stable angina (37 patients) or unstable angina (18 patients) were recruited. Patients with suspected unstable angina were simultaneously included in the other study aiming at investigating the value of 18 F-FDG imaging in the diagnosis of unstable angina [11]. Angina was well controlled in all patients and no new onset of angina occurred for > 40 h before the entry to the present study.…”

“…Exercise 99m Tc-sestamibi images were obtained as previously described using a dual-head, large-field-of-view SPECT (Infinia; GE Healthcare, Milwaukee, Wisconsin, USA), equipped with ultra-high-energy parallel-hole collimators [9, 11]. Resting 99m Tc-sestamibi images were obtained using the same SPECT with ultra-high-energy parallel-hole collimators or low-energy high-resolution parallel-hole collimators.…”

“…Therefore, myocardial 18 F-deoxyglucose ( 18 F-FDG) imaging under fasting conditions is in theory a potential method to detect myocardial ischemia. Previous studies have observed enhanced 18 F-FDG uptake in myocardium supplied by stenotic coronaries or in myocardium with perfusion abnormalities [3–11]. However, whether the enhanced 18 F-FDG uptake is induced by myocardial ischemia is controversial [12], since non-ischemic myocardium can also exhibit varying extents of 18 F-FDG uptake even under strict dietary control [13–15].…”

“…Several studies have investigated the distribution pattern of 18 F-FDG in patients without heart disease [11, 16, 17]. These studies found that most individuals had no obvious 18 F-FDG uptake, or had diffuse but homogenous uptake.…”

“…Even if some patients showed focal uptake, the uptake was usually located on the basal segments, including the papillary muscle. We had adopted these classification methods to differentiate ischemic from physiological uptake in patients with suspected unstable angina who underwent resting 18 F-FDG imaging, and obtained favorable diagnostic results [11]. In this study, we evaluated the diagnostic performance of 18 F-FDG imaging in patients with suspected CAD using the classification of 18 F-FDG distribution pattern.…”