Module 14. Myocardial Viability with PET Clinical Data-Myocardial Viability with PET Clinical Data (Slides)

Myocardial Viability with PET Clinical Data (Slides)

Pdf Summary

This document is Part VI of a series on non-perfusion PET imaging, specifically focusing on myocardial viability and PET clinical data. The learning objectives include understanding the concepts of ischemia, viability, hibernation, and scar; describing the role of 18F-FDG PET imaging in assessing myocardial viability; explaining how 18F-FDG PET imaging data is used in the diagnosis of viability imaging; describing the various 18F-FDG PET viability protocols and patient preparation; and listing critical components for interpretation and reporting of 18F-FDG PET viability studies.<br /><br />The document presents two patient cases. Patient 1 is a 54-year-old female with a history of coronary artery disease (CAD) and ongoing chest pain. Patient 2 is a 70-year-old female with a total proximal left anterior descending (LAD) occlusion and reduced left ventricular ejection fraction (LVEF) but no angina. The document raises questions about further testing and the interpretation of PET imaging findings in these cases.<br /><br />The document also discusses when to use 18F-FDG cardiac PET for viability assessment, including patients with normal LVEF, CAD without targets for revascularization, normal coronary arteries with normal or abnormal LVEF, and prior PET FDG scans showing no viability. It presents a decision-making algorithm for patients with an EF less than 40%.<br /><br />The limitations of past literature in viability imaging techniques are discussed, highlighting the need for randomized trials and the challenges in patient selection, protocol standardization, and assessment of long-term outcomes.<br /><br />The document also mentions recent developments in myocardial viability, including the PARR-2 trial comparing PET-guided therapy versus standard care. The improvement in ejection fraction as a function of scar is shown, with longer event-free survival observed in the PET-guided therapy group.<br /><br />Patient preparation, image acquisition, and display techniques for 18F-FDG PET viability studies are described. The interpretation of findings, including matching and mismatching perfusion and glucose uptake, and recommendations based on those findings are also discussed.<br /><br />Overall, the document provides an overview of the role of 18F-FDG PET imaging in the assessment of myocardial viability and presents clinical data and considerations related to this imaging modality.

Keywords

non-perfusion PET imaging

myocardial viability

18F-FDG PET imaging

scar

coronary artery disease

left ventricular ejection fraction

PET-guided therapy

patient preparation

glucose uptake

clinical data