Key result
Single-photon emission computed tomography (SPECT) imaging provides reasonably good sensitivity and specificity for detecting viable myocardium and predicting clinical responses to revascularization.
Why the study?
Does SPECT imaging accurately assess myocardial viability and predict response to revascularization in patients with coronary artery disease and left-ventricular dysfunction?
Does SPECT imaging accurately assess myocardial viability and predict response to revascularization in patients with coronary artery disease and left-ventricular dysfunction?
SPECT imaging remains a valuable and widely available diagnostic modality for assessing myocardial viability and predicting outcomes after revascularization in ischemic cardiomyopathy.
Supports SPECT viability assessment in ischemic cardiomyopathy; leaves open need for head-to-head trials versus PET/CMR.
PURPOSE OF REVIEW: Cardiac imaging is evolving rapidly. Appropriate use of this technology could reduce morbidity and mortality, but inappropriate use could have a significant financial burden. Single-photon emission computed tomography imaging is widely available. This review summarizes the clinical utility and limitations of the prognostic role of single-photon emission computed tomography imaging for myocardial viability in patients with coronary artery disease and left-ventricular dysfunction. RECENT FINDINGS: 201Tl single-photon emission computed tomography, 99mTc single-photon emission computed tomography with sestamibi or tetrofosmin, and 18F-fluorodeoxyglucose single-photon emission computed tomography are validated tools for assessing myocardial viability. These techniques have a very similar predictive value in determining regional and global response to revascularization. 201Tl single-photon emission computed tomography viability studies are predictive of reverse left-ventricular remodeling, symptom improvement, and patient outcome after revascularization. Combination imaging with dual-isotope simultaneous acquisition single-photon emission computed tomography or positron-emission tomography/single-photon emission computed tomography may improve the positive and negative predictive values of single-photon emission computed tomography-based viability studies. SUMMARY: Single-photon emission computed tomography-based myocardial viability testing is an important diagnostic modality due to widespread availability and reasonably good sensitivity and specificity for detecting viable myocardium and predicting clinical and functional responses to revascularization. In the future single-photon emission computed tomography viability techniques may have a prognostic role in predicting responses to cardiac resynchronization therapy and evaluating myocardial stem-cell transplantation.
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Patel et al. (2006) conducted a review in Coronary artery disease and left-ventricular dysfunction. Single-photon emission computed tomography (SPECT) imaging was evaluated. Single-photon emission computed tomography (SPECT) imaging provides reasonably good sensitivity and specificity for detecting viable myocardium and predicting clinical responses to revascularization.
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