Module 19. Case review - Non-Perfusion Imaging – Viability-Case review - Non-Perfusion Imaging

Case review - Non-Perfusion Imaging – Viability (Slides)

Pdf Summary

This document is a case review on non-perfusion viability imaging, specifically focusing on 18F-FDG PET imaging. The use of 18F-FDG PET imaging is discussed as a way to differentiate scar tissue from hibernating tissue in the myocardium. The document explains how 18F-FDG competes with glucose for transport and phosphorylation in the heart, and how different conditions affect the preferred energy substrate for the heart.<br /><br />The document also discusses the clinical application of determining whether a reduction in myocardial blood flow is due to scarred or hibernating myocardium. It states that hibernating myocardium, which is characterized by chronic reduction of blood flow and overdependence on glucose, will show uptake of 18F-FDG. On the other hand, scarred myocardium, which is the result of myocardial cell death, will not show 18F-FDG uptake.<br /><br />The document includes several case studies in which PET rest/viability imaging was performed for patients with occluded arteries and varying degrees of left ventricular dysfunction. The cases demonstrate the importance of determining myocardial viability for clinical decisions regarding revascularization.<br /><br />Overall, the document emphasizes the role of PET imaging in differentiating between normal, ischemic, hibernating, and scarred myocardium, and highlights the importance of patient preparation for optimal imaging results. It concludes that normal resting perfusion, ischemia, and hibernation indicate viable myocardium that can benefit from revascularization, while scarred myocardium is non-viable and unlikely to benefit from revascularization.

Keywords

non-perfusion viability imaging

18F-FDG PET imaging

scar tissue

hibernating tissue

myocardium

glucose transport

glucose phosphorylation

myocardial blood flow

myocardial viability

revascularization