Positron emission tomography with F-18-fluoro-2-deoxyglucose in cardiological diagnosis

This clinically oriented review presents main principles of metabolism of cardiac muscle, pathophysiology of myocardial hibernation and stunning, as well as methodological principles of positron emission tomography (PET) of the heart with F-18-fluoro-2-deoxyglucose (F-18-FDG). Diagnostic and prognostic value of F-18-FDG PET and scintigraphic sings of disturbed myocardial viability, contractility and metabolism are also described. Efficacy of F-18-FDG PET is compared with other imaging methods such as radionuclide, ultrasound and radiological. Literature data and clinical cases demonstrate importance of preoperative diagnosis of hibernating myocardium in patients with ischemic heart disease. F-18-FDG PET is a basic method of detection of potentially reversible pathological states of the heart (hibernation and stunning); it has high sensitivity and specificity as well as predictive power in relation to forthcoming course of ischemic heart disease. This noninvasive method of investigation provides unique information on severity of ischemic heart disease for stratification of patients in risk groups and selection of candidates for coronary artery bypass surgery or cardiac transplantation.