Fluorine 18-labeled fluorodeoxyglucose myocardial single-photon emission computed tomography: An alternative for determining myocardial viability

The identification of hibernating myocardium in patients with poor ventricular function has become increasingly important as investigators demonstrate an improvement in ventricular performance in patients with injured but viable myocardium who undergo surgical revascularization. Modifications of ²⁰¹Tl redistribution protocols and rest/stress ^99mTc-labeled hexakis-2-methoxy-2-methyl propylisonitrile perfusion studies continue to underestimate myocardial viability compared with resting ¹⁸F-labeled fluorodeoxyglucose (¹⁸FDG) positron emission tomography. The combined data from multiple investigators suggest that ¹⁸FDG single-photon emission computed tomograpy used in combination with cardiac perfusion agents, either sequentially or with simultaneous dual-isotope acquisition, may provide an acceptable alternative to positron emission tomographic imaging for the detection of hibernating myocardium.