Diagnosis

A key issue for patients who have been diagnosed with coronary artery disease is to determine whether there has been permanent damage to the heart muscle (myocardium) due to reduced supply of nutrients. This means looking at areas of the heart that are not functioning properly and determining whether the tissue is still alive (viable). PET/CT imaging using a glucose-based radiopharmaceutical, is utilized by physicians to determine myocardial viability and whether the heart can recover if blood supply is restored by revascularization.

Myocardial viability imaging utilizes a glucose-based radiopharmaceutical, which helps the physician determine if areas of the heart tissue demonstrates an ability to metabolize glucose. If the heart muscle has been damaged permanently, it will not show any glucose metabolism, and the patient will not benefit from revascularization or by having blood supply re-established. Such a patient would need medical therapy or a heart transplant. About 35% of coronary artery disease patients who receive bypass surgery or angioplasty to revascularize the heart do not show improvement in cardiac function because the affected tissue is permanently damaged and not reversible.1

PET/CT imaging is a sensitive technique for the identification of viable myocardial tissue in patients with coronary disease. Metabolic assessment with PET/CT imaging appears to be the most accurate test available for determining myocardial viability and therefore is considered by many to be the gold standard for predicting recovery of left ventricular function prior to surgical revascularization.2

References:
  1. Gambhir et al. A Tabulated Summary of FDG PET Literature. J Nucl Med 2001; 42:1S-93S
  2. Clinical Application and Economic Implications of PET in the Assessment of Myocardial Viability: A Retrospective Study. ICP Cardiology Task Force.