FDG PET/CT myocardial perfusion imaging

What is it?

It is a method that uses a radioactive tracer, 18F-fluorodeoxyglucose (18F-FDG), which is metabolized and accumulates in viable myocardial cells.

The term viable myocardium indicates a myocardial area that is hypofunctioning and hypoperfused but still metabolically active (i.e., able to utilize glucose), and therefore susceptible to functional recovery if adequately reperfused after revascularization.

The study of viability with 18F-FDG is combined with the examination of myocardial perfusion by PET or SPECT: the perfusion images and those related to glucose metabolism are compared to identify the presence, extent and severity of perfusion defects corresponding or not to areas of altered metabolism (match/mismatch between perfusion and metabolism); the presence of an area not perfused but capturing FDG identifies a still viable myocardial area.

When is this exam indicated?

  • coronary artery disease

How is it performed?

It is necessary to fast for at least 6 hours, and it is fundamental to

notify the nuclear physician in case of diabetes.

Prior to the 18FDG PET scan, a perfusion study (resting SPET or NH3-PET) must be performed to compare 18FDG distribution images with perfusion images in order to identify hypoperfused but viable myocardial areas.

In order to maximize the extraction of the tracer from the myocardial cells, glucose is administered orally or intravenously associated with insulin, also intravenously in cases of high glycemic values.

After stabilization of glycemic values, intravenous injection of 18F-FDG tracer is administered.

Image acquisition on the tomograph starts in 45-60 minutes after injection.

For the acquisition of images the patient will be placed on the PET scanner bed for about 15 minutes.

Contraindications

The examination cannot be performed in case of pregnancy or breastfeeding/lactation.

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