@article {AlMohammade000581, author = {Abdallah AlMohammad and Murdoch Y Norton and Andrew E Welch and Peter F Sharp and Stephen Walton}, title = {Gated metabolic myocardial imaging, a surrogate for dual perfusion-metabolism imaging by positron emission tomography}, volume = {4}, number = {2}, elocation-id = {e000581}, year = {2017}, doi = {10.1136/openhrt-2016-000581}, publisher = {Archives of Disease in childhood}, abstract = {Objective Perfusion-metabolism mismatch pattern on positron emission tomography (PET) predicts hibernating myocardium. We assess the ECG-gated metabolic PET as a surrogate for the perfusion-metabolism mismatch pattern on PET imaging.Methods 13N-Ammonia (NH3) and 18F-fluorodeoxyglucose (FDG) are respectively perfusion and metabolism PET tracers. We used ECG gating to acquire FDG-PET to collect wall thickening (mechanical) data. These allow detection of metabolic activity in regions with reduced contraction (metabolism-mechanical mismatch pattern). We had two data sets on each patient: perfusion-metabolism and metabolism-mechanical data sets. We tested the hypothesis that metabolism-mechanical pattern on PET could predict perfusion-metabolism mismatch pattern.Results We studied 55 patients (48 males), mean age 62 years. All were in sinus rhythm, and had impaired left ventricular contraction. Perfusion-metabolism mismatch pattern was found in 26 patients. Metabolism-mechanical mismatch pattern was found in 25 patients. The results were concordant in 52 patients (95\%). As a surrogate for perfusion-metabolism mismatch pattern, demonstration of metabolism-mechanical mismatch pattern is highly sensitive (92\%) and specific (97\%). In this cohort, the positive and negative predictive accuracy of the new method are 96\% and 93\%, respectively.Conclusion Metabolism-mechanical mismatch pattern could predict perfusion-metabolism mismatch pattern in patients with myocardial viability criteria on PET. Prospective validation against the gold standard of improved myocardial contraction after revascularisation is needed.}, URL = {https://openheart.bmj.com/content/4/2/e000581}, eprint = {https://openheart.bmj.com/content/4/2/e000581.full.pdf}, journal = {Open Heart} }