Myocardial Viability Assessment by PET: 82Rb Defect Washout Does Not Predict the Results of Metabolic–Perfusion Mismatch

PET is a sensitive technique for the identification of viable myocardial tissue in patients with coronary disease. Metabolic assessment with 18F-FDG is considered the gold standard for assessment of viability before surgical revascularization. Prior research has suggested that viability may be assessed with washout of 82Rb between early and late resting images. Our objective was to determine whether assessment of myocardial viability with 82Rb washout is reliable when compared with PET using 18F-FDG. Methods: We performed PET for 194 patients referred for PET 18F-FDG/82Rb to assess viability for clinical indications. We included 151 patients with resting defects 10 % of the left ventricle (LV) (n 159 defects). Patients with smaller resting 82Rb defects (10 % LV) were excluded for the purpose of this study. PET images acquired with 82Rb and 18F-FDG defined viability by the mismatch between metabolis