Best noninvasive investigation to check for bility of myocardium is:
(A) FDG-18 PET CT (B) MIBG scintigraphy (C) Echocardiogram (D) Thallium scintigraphy
(A) Ans: A. FDG-18 PET CT(Ref Harrison 19/e p270 e4, 18/e p1846).Best noninvasive investigation for myocardium bility check = FDG-18 PET CTViable myocardium:Non-contracting ischemic myocardium at rest.Has full potential to recover its function (On self or on revascularization).PET:Gold standard for assessment of myocardium bility.Identifies ischemic or hibernating myocardium in 10-20% of fibrotic or infracted regions.Uses thallium & technetium labeling.Positron-emitting tracer F-18 fluorodeoxyglucose (FDG) assesses myocardial glucose metabolism - Hence an indicator of myocardial bility.Evaluation methods of myocardial bility:Mainly in ischemic cardiomyopathy patients.Myocardial perfusion imaging (with SPECT or PET) combined with metabolic imaging (i.e., fluorodeoxyglucose I FDGJ PET).Excellent alternative:Thallium-201 SPECT imaging (hospitals lacking PET scanning).