[18F]Fluorodeoxyglucose as a memory marker of transient myocardial ischaemia

Nucl Med Commun. 2007 Feb;28(2):89-94. doi: 10.1097/MNM.0b013e328013eaa5.

Abstract

Background: Experimental data have shown that glucose utilization increases during acute myocardial ischaemia, and may persist for up to 24 h. Whether fluorodeoxyglucose (FDG) uptake can be imaged as a memory marker of ischaemia in humans is unknown.

Methods: Patients with mild-to-moderate ischaemia on exercise single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) underwent repeat exercise testing within 1-2 weeks. Positron emission tomography (PET) was performed after injection of FDG 60 min post-exercise. SPECT and PET images were assessed visually, aided by circumferential profile-based analysis modified for 'hot-spot' imaging.

Results: Twelve men with stress SPECT ischaemia (mean age, 69 years; nine with known coronary artery disease) were studied. The mean rate-pressure products for the first (SPECT) and second (FDG PET) exercise tests were similar (22,841+/-7321 vs. 22,680+/-7393 mmHg x bpm, P=NS). Overall, six of 12 patients studied had evidence of FDG uptake. The extent of ischaemia on SPECT was similar in FDG positive and FDG negative patients (summed difference score 10.6+/-6.9 vs. 8.0+/-1.6, P=NS). All patients with a positive FDG scan had uptake in either an ischaemic SPECT region or in a territory with known CAD by angiography.

Conclusion: Regional myocardial uptake of FDG is enhanced even when injected 1 h post-exercise stress in a subset of patients with ischaemia on exercise SPECT MPI. The ability to image FDG uptake injected 1 h after an ischaemic episode suggests the potential utility of FDG as a memory marker of transient ischaemia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angiography / methods
  • Fluorodeoxyglucose F18 / pharmacokinetics*
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Myocardial Ischemia / drug therapy*
  • Myocardium / pathology
  • Perfusion
  • Positron-Emission Tomography / methods*
  • Pressure
  • Reproducibility of Results
  • Time Factors
  • Tomography, Emission-Computed, Single-Photon / methods*

Substances

  • Fluorodeoxyglucose F18