Re: cardiac PET scan

[John Wendel]

Dr.Andrew B.Chung If resting sestamibi images demonstrate a mild
reduction in tracer accumulation,however FDG PET images demonstrate a
disproportionately increased amount of FDG tracer accumulation in the
same region in comparison to the degree of sestamibi would the above
findings in any way be a dead muscle tissues (old heart attacks)? I know
that above findings can be related to diaphragmatic attenuation artifact
and also can be related to physiologic variant and also can be mild
ischemia,but can the above findings be in any way dead muscle tissues
(old heart attacks)?Thanks

 

[Patrick Ford]

[email protected] (John Wendel) wrote in message news:<[email protected]>...
> Dr.Andrew B.Chung If resting sestamibi images demonstrate a mild
> reduction in tracer accumulation,however FDG PET images demonstrate a
> disproportionately increased amount of FDG tracer accumulation in the
> same region in comparison to the degree of sestamibi would the above
> findings in any way be a dead muscle tissues (old heart attacks)? I know
> that above findings can be related to diaphragmatic attenuation artifact
> and also can be related to physiologic variant and also can be mild
> ischemia,but can the above findings be in any way dead muscle tissues
> (old heart attacks)?Thanks

If there is F-18 FDG in the tissue it is not dead! What level of
certainty do you want? This is as about as certain as any medical
test can get. If you want to parse that a couple of patients out of a
thousand with the above findings might have a tiny almost microscopic
sub endocardial scar, sure it is not 100%, but it is the current Gold
Standard for myocardial viability! Anyone who clams Test X or Y are
'better' needs to tell you compared to what and how that determination
was made.

If you need more certainty than the current Gold Standard test, why
don't you get a Myocardial Scar MRI study done? Since PET and MRI are
using two distinct methods, if both show no scar then the post test
probability of scar would be essentially zero.