Myocardial Metabolic Imaging in the Clinical Setting

2009 ◽  
Vol 5 (1) ◽  
pp. 15
Author(s):  
Nagara Tamaki ◽  
Yuji Kuge ◽  
Keiichiro Yoshinaga ◽  
◽  
◽  
...  
Keyword(s):  
Heart Failure ◽  
Fatty Acid ◽  
Clinical Setting ◽  
Photon Emission ◽  
Tca Cycle ◽  
Emission Tomography ◽  
Metabolic Imaging ◽  
Myocardial Uptake ◽  
Glucose Utilisation ◽  
Myocardial Metabolic Imaging

Glucose and free fatty acids are a major energy source in the myocardium. Metabolic imaging with single photon emission tomography (SPECT) and positron emission tomography (PET) have been widely used for the evaluation of the pathophysiology of coronary artery disease (CAD) and heart failure. 18F fluorodeoxyglucose (FDG) is a glucose analogue that is used to measure myocardial glucose utilisation. The myocardial uptake of a modified branched fatty acid, 15-(p-[iodine-123] iodophenyl)-3-(R,S) methylpentadecanoic acid (BMIPP), reflects the activation of fatty-acid metabolism by co-enzyme A (CoA) and indirectly reflects cellular adenosine triphosphate (ATP) production. The turnover rate of the tricarboxylic acid (TCA) cycle reflects the rate of overall myocardial oxidative metabolism. 11C acetate is readily metabolised to CO2 almost exclusively through the TCA cycle. These three major agents have been most commonly used for probing myocardial energy metabolism in vivo. Such metabolic imaging has been used for assessing myocardial viability on the basis of persistent glucose utilisation in ischaemic but viable myocardium. BMIPP and FDG have been identified for locating a recent history of myocardial ischaemia. Furthermore, metabolic imaging is promising for the assessment of the pathophysiology of heart failure and the treatment effect of various drugs, as well as mechanical treatments. In this article we will provide an overview of the application of myocardial metabolic imaging in a clinical setting.

scholarly journals Nuclear Imaging of Glucose Metabolism: Beyond 18F-FDG

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Han Feng ◽  
Xiaobo Wang ◽  
Jian Chen ◽  
Jing Cui ◽  
Tang Gao ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Tumor Imaging ◽  
Single Photon ◽  
Photon Emission ◽  
Nuclear Imaging ◽  
Emission Tomography ◽  
Metabolic Imaging ◽  
Emission Computed Tomography ◽  
Positron Emission

Glucose homeostasis plays a key role in numerous fundamental aspects of life, and its dysregulation is associated with many important diseases such as cancer. The atypical glucose metabolic phenomenon, known as the Warburg effect, has been recognized as a hallmark of cancer and serves as a promising target for tumor specific imaging. At present, 2-deoxy-2-[18F]fluoro-glucose (18F-FDG)-based positron emission tomography/computed tomography (PET/CT) represented the state-of-the-art radionuclide imaging technique for this purpose. The powerful impact of 18F-FDG has prompted intensive research efforts into other glucose-based radiopharmaceuticals for positron emission tomography (PET) and single-photon emission computed tomography (SPECT) imaging. Currently, glucose and its analogues have been labeled with various radionuclides such as 99mTc, 111In, 18F, 68Ga, and 64Cu and have been successfully investigated for tumor metabolic imaging in many preclinical studies. Moreover, 99mTc-ECDG has advanced into its early clinical trials and brings a new era of tumor imaging beyond 18F-FDG. In this review, preclinical and early clinical development of glucose-based radiopharmaceuticals for tumor metabolic imaging will be summarized.

Ergebnisse der Fettsäure-SPECT des Myokards bei der koronaren Herzerkrankung

1986 ◽  
Vol 25 (03) ◽  
pp. 90-98 ◽  
Author(s):  
F. F. Knapp ◽  
J. Nitsch ◽  
J. Kropp ◽  
K. Reichmann ◽  
C. Winkler ◽  
...  
Keyword(s):  
Fatty Acid ◽  
Single Photon ◽  
Photon Emission ◽  
Clinical Results ◽  
Therapeutic Interventions ◽  
Metabolic Imaging ◽  
Local Flow ◽  
New Developments ◽  
Diagnostic Applications

New developments in radiopharmacology of 123l-labeled metabolic tracers and single-photon emission computerized tomography (SPECT) allow now-a-days the assessment of parameters of cardiac energy metabolism in well-defined areas of the heart muscle. This article will present a brief outline of the basic pathophysiological principles used in the application of 123l-labeled phenyl fatty acids for the evaluation of CAD. First clinical results suggest an important application of cardiac fatty acid metabolic imaging to the detection, localisation and conceivable quantitation of myocardial ischemia, myocardial infarction and assessment of tissue viability. In addition to the diagnostic applications in CAD, cardiac fatty acid metabolic imaging may provide new perspectives to pathophysiological investigations of the coupling of local flow and substrate utilisation in vivo and the effect of therapeutic interventions.

FDG gamma camera PET equipped with one inch crystal and XCT

2006 ◽  
Vol 45 (04) ◽  
pp. 163-170
Author(s):  
A. Khorsand ◽  
S. Graf ◽  
G. Dobrozemsky ◽  
S. Oezer ◽  
K. Kletter ◽  
...  
Keyword(s):  
Clinical Studies ◽  
Gamma Camera ◽  
Single Photon ◽  
Photon Emission ◽  
Regional Analysis ◽  
Correlation Coefficients ◽  
Emission Tomography ◽  
Metabolic Imaging ◽  
99Mtc Tetrofosmin ◽  
Dedicated Pet

SummaryMetabolic imaging with 2-[fluorine-18]-fluoro- 2-deoxy-D-glucose (FDG) is actually considered as the best method to detect and quantitatively assess myocardial tissue viability. The aim of this study was to investigate the accuracy of FDG gamma camera positron emission tomography (GCPET) imaging equipped with one inch NaI crystals in comparison to FDG dedicated PET (dPET) imaging as a „gold standard“ in phantom and clinical studies. Patients, methods: Nineteen patients with coronary artery disease (CAD) underwent both imaging modalities. Phantom and clinical GCPET imaging were performed with a dual-headed, coincidence based gamma camera equipped with 1 inch thick NaI crystals and an x-ray tube (XCT) for attenuation correction (AC), as well as with a dedicated PET scanner with AC. 99mTc tetrofosmin single-photon emission tomography (SPET) studies were performed for assessment of myocardial perfusion, with AC. Results: Phantom studies showed a significant relation in segmental activity between FDG imaging with AC using GCPET and dPET (r = 0.91, p <0.001). In clinical studies with AC correlation coefficients of mean segmental FDG uptake and regional defect size were r = 0.87 (p <0.0001) and r = 0.83 (p <0.0001), respectively. In regional analysis close agreement was even found in the most attenuated regions of the heart if AC was used in GCPET imaging. The overall agreement for detection of viable myocardium was 81% between FDG-dPET (AC) and FDG-GCPET (AC) and 74% between FDG-dPET (AC) and FDG-GCPET (NC). Conclusion: This study suggests that the assessment of myocardial metabolism by means of FDG is feasible with a coincidence based gamma camera equipped with 1 inch thick NaI crystals if AC is performed. The results reveal a close concordance and agreement between FDG-dPET (AC) and FDG-GCPET (AC) as compared to FDG-GCPET (NC).

scholarly journals Synthesis and evaluation of radiogallium-labeled long-chain fatty acid derivatives as myocardial metabolic imaging agents

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261226
Author(s):  
Nurmaya Effendi ◽  
Kenji Mishiro ◽  
Hiroshi Wakabayashi ◽  
Malwina Gabryel-Skrodzka ◽  
Kazuhiro Shiba ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Fatty Acid ◽  
Heart Diseases ◽  
Primary Energy ◽  
Metabolic Imaging ◽  
Imaging Agents ◽  
Long Chain Fatty Acids ◽  
Myocardial Metabolic Imaging ◽  
Long Chain ◽  
Chain Fatty Acids

Since long-chain fatty acids work as the primary energy source for the myocardium, radiolabeled long-chain fatty acids play an important role as imaging agents to diagnose metabolic heart dysfunction and heart diseases. With the aim of developing radiogallium-labeled fatty acids, herein four fatty acid-based tracers, [67Ga]Ga-HBED-CC-PDA, [67Ga]Ga-HBED-CC-MHDA, [67Ga]Ga-DOTA-PDA, and [67Ga]Ga-DOTA-MHDA, which are [67Ga]Ga-HBED-CC and [67Ga]Ga-DOTA conjugated with pentadecanoic acid (PDA) and 3-methylhexadecanoic acid (MHDA), were synthesized, and their potential for myocardial metabolic imaging was evaluated. Those tracers were found to be chemically stable in 0.1 M phosphate buffered saline. Initial [67Ga]Ga-HBED-CC-PDA, [67Ga]Ga-HBED-CC-MHDA, [67Ga]Ga-DOTA-PDA, and [67Ga]Ga-DOTA-MHDA uptakes in the heart at 0.5 min postinjection were 5.01 ± 0.30%ID/g, 5.74 ± 1.02%ID/g, 5.67 ± 0.22%ID/g, and 5.29 ± 0.10%ID/g, respectively. These values were significantly lower than that of [123I]BMIPP (21.36 ± 2.73%ID/g). For their clinical application as myocardial metabolic imaging agents, further structural modifications are required to increase their uptake in the heart.

Heart failure

ESC CardioMed ◽  
2018 ◽  
pp. 600-603
Author(s):  
Danilo Neglia ◽  
Oliver Gaemperli
Keyword(s):  
Heart Failure ◽  
Myocardial Perfusion ◽  
Radionuclide Imaging ◽  
Single Photon ◽  
Photon Emission ◽  
Treatment Strategies ◽  
Radionuclide Ventriculography ◽  
Myocardial Perfusion Spect ◽  
Emission Tomography ◽  
Positron Emission

Heart failure (HF) has turned into an increasing global socioeconomic issue associated with a high morbidity and mortality. Cardiac radionuclide imaging offers important clinical information for risk stratification and tailored treatment strategies in patients with HF. Ischaemic cardiomyopathy is the most common cause of HF. Left and right ventricular function can be assessed and quantified with radionuclide ventriculography (RNV) or gated scintigraphic studies. Additionally, radionuclide imaging may help to assess functional and metabolic integrity of dysfunctional myocardium. Chronic myocardial ischaemia can lead to variable reversible states of contractile impairment termed myocardial stunning or hibernation. Radionuclide techniques including positron emission tomography with 18F-fluorodeoxyglucose or myocardial perfusion scintigraphy can identify viable myocardium with the potential for functional recovery, and thereby guide revascularization procedures. Increased sympathetic myocardial innervation assessed by 131I-metaiodobenzylguanidine (MIBG) single-photon emission tomography (SPECT) is associated with poorer HF outcomes and higher rates of sudden cardiac death or arrhythmia. Finally, left ventricular mechanical dyssynchrony can be evaluated using Fourier-transformed phase analysis of RNV or gated myocardial perfusion SPECT. This approach could potentially be useful to guide targeted resynchronization therapy in the future.

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