The predictive value of 201Tl rest-redistribution and 18F-fluorodeoxyglucose SPECT for wall motion recovery after recent reperfused myocardial infarction

Tl-201 and F-18-FDG are useful for acute myocardial infarction (MI) assessment. The goal of this study was to compare their predictive value for wall motion recovery in the culprit area after a recent reperfused MI using SPECT technique. Methods: Forty-one patients (mean age: 56 +/- 12 years) were included, 81% of them male; all were studied within 1-24 days post MI. They underwent angioplasty in 27 cases (12 primary); bypass grafting in 10 cases and successful thrombolysis in 4. SPECT Tl-201 injected at rest and redistribution (R-R) and also F-18-FDG, were performed on different days. Processed tomograms were interpreted blinded to clinical or angiographic data. Segmental wall motion assessed with echocardiography at baseline was compared with the 3 month follow up. Results: Sensitivity [Confidence Interval] for (TI)-T-201 R-R was 74.6% [60.5-84.5], for FDG it was 82.1% [70.8-90.4]; specificities were 73% [64.3-80.5] and 54.8% [45.6-63.7], respectively. F-18-FDG tended to be more sensitive than Tl-201 R-R, but the latter was more specific (p < 0.0004). Both Tl-201 R-R and F-18-FDG presented high negative predictive value (p: ns). Conclusion: In recent MI, SPECT Tl-201 R-R is a valuable and widely available technique for viability detection, with similar sensitivity and significant better specificity than SPECT F-18-FDG.