A precise oral glucose loading 18F-FDG PET myocardial metabolic imaging protocol in coronary artery disease patients complicated by diabetes mellitus: an exploratory prospective cohort study

Figures

• 

  Figure 1. Myocardial 18F-FDG image quality was evaluated according to 5-point score system.

• 

  Figure 2. Distribution of myocardial 18F-FDG image quality scores when subgrouped and compared between those with different blood glucose at time of FDG injection.

• 

  Figure 3. Distribution of myocardial 18F-FDG image quality scores when subgrouped and compared between those with different diabetic treatment regimens.

• 

  Figure 4. Comparison of image quality among groups stratified by blood glucose at time of FDG injection. Stacked bar chart illustrates the proportions of patients with excellent (red) and “remaining” (green) image quality, categorized by blood glucose at time of FDG injection: >7.77 mmol/L (n = 51), 5.55–7.77 mmol/L (n = 101), and <5.55 mmol/L (n = 27). Percentage values for each category are labeled on the corresponding bars. Patients with blood glucose 5.55–7.77 mmol/L or <5.55 mmol/L at FDG injection exhibited a significantly higher proportion of excellent-quality images than those with glucose levels >7.77 mmol/L.

• 

  Figure 5. Comparison of image quality between patients stratified by blood glucose at time of FDG injection. Stacked bar chart illustrates the proportions of images graded as excellent (red) and “remaining” (green), including patients with blood glucose at time of FDG injection 5.55–7.77 mmol/L (n = 101) and <5.55 mmol/L (n = 27). Corresponding percentage values are marked on each bar. No statistically significant differences in image quality were observed between the two subgroups.

• 

  Figure 6. Rest myocardial perfusion 99mTc-MIBI SPECT images demonstrating mismatch with 18F-FDG PET images in patient with CHD. SPECT shows moderate hypoperfusion in inferior and inferolateral walls, whereas PET shows normal 18F-FDG uptake, consistent with hibernating myocardium.

• 

  Figure 7. Rest myocardial perfusion 99mTc-MIBI SPECT images demonstrating match with 18F-FDG PET/CT images in patient with CHD. SPECT shows severe perfusion defect in inferior, inferolateral walls and apical, and PET shows predominant absence of 18F-FDG uptake, thus, findings consistent with scarred myocardium.