Assessment of Myocardial Viability by Use of 11 C-Acetate and Positron Emission Tomography

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Abstract
Background Dual positron emission tomography (PET) imaging with a perfusion tracer and 18F-fluorodeoxyglucose (FDG) can detect myocardial viability. This approach may be replaced by a single 11C-acetate study, which enables quantification of both regional blood flow and oxidative metabolism. The significance of acetate-derived indexes for myocardial viability is examined. Methods and Results Thirty postinfarct patients with akinetic ventricular segments, a mean ejection fraction of 42±11%, and high-grade coronary obstructions were studied with serial 11C-acetate PET scanning before and 7±5 months after coronary revascularization. Acetate PET was tested against FDG and serial assessments of segmental wall motion. Sixty of 155 severely dysfunctional LV segments improved postoperatively, and regional blood flow increased. Flow estimates after revascularization suggested little fibrosis in reversible segments. At baseline, blood flows differed between normal myocardium, reversible dysfunction, and irreversibl...

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