CARDIOLOGY, Sousa MCM

Abstracts XIX Brazilian Congress of Nuclear Medicine

1. CARDIOLOGY

1.6 - ORAL GLUCOSE OVERLOAD vs HYPERINSULINEMIC EUGLYCEMIC CLAMP FOR MYOCARDIAL VIABILITY.

Sousa MCM, Vítola JV, Santos AO, Etchebehere ECSC, Ramos CD, Camargo EE. Division of Nuclear Medicine, Department of Radiology, Campinas State University (UNICAMP), Campinas, and Instituto Rio Preto de Medicina Nuclear, São José do Rio Preto, Brazil.

allan@mn-d.com

[F-18]FDG/PET myocardial images are the gold standard for the detection of myocardial viability. Coincidence imaging and high energy collimator imaging have made this method possible in this country. The purpose of this study was to describe our preliminary data with [F-18]FDG/SPECT. Five non-diabetic male patients (pts) (44-70 yrs) were studied for detection of viable myocardium post infarct using [F-18]FDG and a myocardial perfusion tracer. One pt was studied twice, in a total of 6 studies. Pts were in the fasting state for 6 hours prior to the study. In 5 studies the hyperinsulinemic euglycemic clamp was used; in 1 pt the study was performed after oral glucose overload. Pts received 370 MBq (10 mCi) of [F-18]FDG, 20 to 30 minutes after the clamp. A perfusion tracer (370 MBq) was injected immediately after beginning of the clamp or immediately after [F-18]FDG injection. In 4 studies [Tc-99m]sestamibi was used and in the remaining 2, [Tc-99m]furofosmin was used. Simultaneous [F-18]FDG and [Tc-99m]sestamibi SPECT were begun 30 minutes after [F-18]FDG injection, using a scintillation camera equipped with high energy collimators. Perfusion and metabolism images were analyzed together. Clamp images were of good quality; oral glucose overload images had a higher background activity, but were adequate for interpretation. Three studies were positive for viable myocardium and 3 were negative. [F-18]FDG/SPECT is possible in this country and offers adequate images for interpretation. Clamp studies were of a better quality in comparison to oral glucose overload studies.