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

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

Pdf Summary

This document discusses the principles and applications of non-perfusion viability imaging using 18F-FDG PET imaging. It explains that 18F-FDG PET imaging is the only FDA-approved technique for myocardial viability and can differentiate scar tissue from hibernating tissue. The patient preparation for the test involves fasting and aerobic conditions to preferentially use fatty acids as fuel in the heart. For non-diabetics, glucose loading after fasting enhances 18F-FDG uptake, while diabetics require exogenous insulin to control blood glucose levels. <br /><br />The document presents several case studies where non-perfusion viability imaging was used to assess myocardial viability and aid in clinical decision-making. The results of the imaging helped differentiate between scar tissue and hibernating tissue, which guided the choice of revascularization or advanced heart failure management for each patient. Other factors such as scar location, left ventricular function, and associated complications like thrombus or mitral regurgitation were also considered.<br /><br />The document emphasizes the importance of differentiating between normal, ischemic, hibernating, and scarred myocardium for clinical decision-making, particularly regarding revascularization. It highlights the need for patient preparation and careful consideration of diabetic patients during the imaging process. Overall, non-perfusion viability imaging with PET provides valuable information for guiding treatment choices and improving patient outcomes.

Keywords

non-perfusion viability imaging

18F-FDG PET imaging

myocardial viability

scar tissue

hibernating tissue

patient preparation

fatty acids

glucose loading

exogenous insulin

clinical decision-making