Comparison of Tc-99m tetrofosmin myocardial perfusion scintigraphy and exercise F18-FDG imaging in detection of myocardial ischemia in patients with coronary artery disease.

BACKGROUND

Direct ischemia imaging with F18-FDG can potentially overcome many limitations of SPECT-MPS inherent to "cold imaging". We compared SPECT-MPS with exercise F18-FDG PET in detection of ischemia in patients with suspected CAD.

METHODS

45 patients with clinical suspicion of CAD without the history of myocardial infarction were prospectively included. All patients underwent Tc-99m tetrofosmin SPECT-MPS and exercise F18-FDG PET imaging within 7 days of SPECT-MPS, and both modalities were compared with coronary angiography for detecting ischemia.

RESULTS

27 patients had an abnormal coronary angiography (at least one coronary artery with stenosis >50%). Exercise F18-FDG performed better than SPECT-MPS in LAD and LCX territory with comparably good performance in RCA territory. Exercise F18-FDG performed better in single-vessel disease and equally good in multi-vessel disease compared to SPECT-MPS. Performance of exercise 18F-FDG study was significantly better than SPECT-MPS (P = .0014) in the analysis of the 81 vascular territories in the 27 patients with abnormal coronary angiography. Performance of exercise F18-FDG was significantly better than SPECT-MPS in detecting ischemia in suspected CAD patients.

CONCLUSION

Exercise F18-FDG imaging is a potentially useful ischemia imaging modality which offers the advantages of direct ischemia imaging in CAD patients.