Myocardial Ischemia Clinical Trial
Official title:
Direct Imaging of Ischemia With 18F-FDG PET Imaging Combined With Coronary Anatomy From CT Coronary Angiography
Coronary artery disease results in narrowing of the blood vessels supplying oxygenated blood to the heart muscle. Diagnosis in patients with symptoms of chest pain is now quickly done with CT coronary angiography. This x-ray test can show narrowed blood vessels but has limited ability to predict the severity of the narrowings in some cases. We have described a new approach using PET exercise 18F-FDG imaging as a method to image areas of heart muscle not getting enough blood during exercise stress. The 18F-FDG images are co-registered with the CT anatomy from the CTA to provide direct evidence of the consequences of the narrowing.
The Investigators and others have demonstrated direct imaging of myocardial ischemia using
18F-Fluorodeoxyglucose (18FDG) with exercise or dipyridamole stress and positron emission
tomography (PET) or single photon emission computed tomography (SPECT). This approach with
"hot-spot" imaging may have greater diagnostic accuracy for ischemia than conventional
"cold-spot" myocardial perfusion imaging.
Recent advances in multi-modality imaging permit fusion of CTA images with PET or SPECT
perfusion images and functional assessment of anatomical CAD. Registration of the 2 data
sets can be optimized using the CT acquired with the PET or SPECT15. 18FDG uptake as a
marker for ischemia can be directly related to the coronary anatomy and guide
revascularization.
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