Phase Difference Network for Efficient Differentiation of Hepatic Tumors with Multi-Phase CT.

Liver cancer has been one of the top causes of cancer-related death. For developing an accurate treatment strategy and raising the survival rate, the differentiation of liver cancers is essential. Multiphase CT recently acts as the primary examination method for clinical diagnosis. Deep learning techniques based on multiphase CT have been proposed to distinguish hepatic cancers. However, due to the recurrent mechanism, RNN-based approaches require expensive calculations whereas CNN-based models fail to explicitly establish temporal correlations among phases. In this paper, we proposed a phase difference network, termed as Phase Difference Network (PDN), to identify two liver cancer, hepatocellular carcinoma and intrahepatic cholangiocarcinoma, from four-phase CT. Specifically, the phase difference was used as interphase temporal information in a differential attention module, which enhanced the feature representation. Additionally, utilizing a multihead self-attention module, a transformer-based classification module was employed to explore the long-term context and capture the temporal relation between phases. Clinical datasets are used in experiments to compare the performance of the proposed strategy versus conventional approaches. The results indicate that the proposed method outperforms the traditional deep learning based methods.

Left Bundle Branch Pacing for Heart Failure and Left Bundle Branch Block Patients With Mildly Reduced and Preserved Left Ventricular Ejection Fraction.

BACKGROUND: Left bundle branch block (LBBB) may induce or aggravate heart failure (HF). Few data are available on patients with HF and LBBB with mildly reduced ejection fraction (HFmrEF; left ventricular ejection fraction [LVEF] 40%-50%) and those with preserved EF (HFpEF. LVEF ≥ 50%). We aimed to assess the long-term outcomes of left bundle branch pacing (LBBP) on cardiac function and remodelling in patients with LBBB and symptomatic HFmrEF and HFpEF. METHODS: Nonischemic cardiomyopathy (NICM) patients with HFmrEF and HFpEF (LVEF from 40% to 60% as defined with the use of echocardiography) with LBBB who successfully underwent LBBP (n = 50) were prospectively included from 4 centres. Patient characteristics and echocardiographic and lead parameters were recorded at implantation and during follow-ups of 1, 3, 6, and 12 months. RESULTS: All patients completed 1-year follow up. The LVEF was significantly improved from 46.5 ± 5.2% at baseline to 60.0 ± 6.1% (n = 50; P < 0.001) after 1-year follow up. Higher ΔLVEF and super-response rate were observed in the HFmrEF group (n = 30) than in the HFpEF group (n = 20). CONCLUSIONS: LBBP improved symptoms and reversed remodelling in patients with LBBB and symptomatic HF at 1-year follow-up. Improvement occurred even in HFpEF patients, and the resynchronisation effect was better in HFmrEF group.

Advances in Antioxidant Applications for Combating 131I Side Effects in Thyroid Cancer Treatment.

Thyroid cancer is the most common endocrine cancer, and its prevalence has been increasing for decades. Approx. 95% of differentiated thyroid carcinomas are treated using 131iodine (131I), a radionuclide with a half-life of 8 days, to achieve optimal thyroid residual ablation following thyroidectomy. However, while 131I is highly enriched in eliminating thyroid tissue, it can also retain and damage other body parts (salivary glands, liver, etc.) without selectivity, and even trigger salivary gland dysfunction, secondary cancer, and other side effects. A significant amount of data suggests that the primary mechanism for these side effects is the excessive production of reactive oxygen species, causing a severe imbalance of oxidant/antioxidant in the cellular components, resulting in secondary DNA damage and abnormal vascular permeability. Antioxidants are substances that are capable of binding free radicals and reducing or preventing the oxidation of the substrate in a significant way. These compounds can help prevent damage caused by free radicals, which can attack lipids, protein amino acids, polyunsaturated fatty acids, and double bonds of DNA bases. Based on this, the rational utilization of the free radical scavenging function of antioxidants to maximize a reduction in 131I side effects is a promising medical strategy. This review provides an overview of the side effects of 131I, the mechanisms by which 131I causes oxidative stress-mediated damage, and the potential of natural and synthetic antioxidants in ameliorating the side effects of 131I. Finally, the disadvantages of the clinical application of antioxidants and their improving strategies are prospected. Clinicians and nursing staff can use this information to alleviate 131I side effects in the future, both effectively and reasonably.

Primary Hepatic Gastrointestinal Stromal Tumor on 18 F-FDG PET/CT Images.

ABSTRACT: Primary hepatic gastrointestinal stromal tumor is an extremely rare type of liver tumor with an unknown origin and poor prognosis and usually lacking specific symptoms. This makes it difficult to make an accurate diagnosis. We report the case of a 56-year-old man with primary hepatic gastrointestinal stromal tumor demonstrating multiple heterogeneous lesions with intense FDG uptake in the liver on PET/CT mimicking hepatocellular carcinoma or sarcoma. Primary hepatic gastrointestinal stromal tumor should be considered among the differential diagnoses when multiple FDG-avid primary liver neoplasms are found in patients with malignant characteristic on PET/CT imaging.

Giant Cell Tumor of Lumbar Vertebrae on MR and 18F- FDG PET/CT: A Case Report and Literature Review.

Teaching Point: Giant cell tumor of bone may show a moderate to high FDG uptake, and attention should be paid to differentiate from malignant tumors.

99mTc-MDP Bone Scan and 18F-FDG PET/CT Imaging of Primary Hepatic Osteosarcoma.

A 65-year-old man presented with abdominal bloating, pain, and nausea for 5 days. Abdominal CT revealed a heterogeneous mass with a large area of calcification, and rupture of the mass was seen around the capsulafibrosa. According to pathological examination after percutaneous puncture biopsy, the histopahological and immunohistochemical findings were suggestive of metastatic or primary hepatic osteosarcoma. Whole body bone scintigraphy demonstrated elevated 99mTc-MDP activity in hepatic mass, but no skeletal lesions. The diagnosis of primary hepatic osteosarcoma was finally confirmed. PET/CT showed hepatic mass with heterogeneous high-uptake, and multiple metastases in portacaval lymph nodes, lungs and the third thoracic vertebra were considered.

Changes of [18F]FDG-PET/CT quantitative parameters in tumor lesions by the Bayesian penalized-likelihood PET reconstruction algorithm and its influencing factors.

BACKGROUND: To compare the changes in quantitative parameters and the size and degree of 18F-fluorodeoxyglucose ([18F]FDG) uptake of malignant tumor lesions between Bayesian penalized-likelihood (BPL) and non-BPL reconstruction algorithms. METHODS: Positron emission tomography/computed tomography images of 86 malignant tumor lesions were reconstructed using the algorithms of ordered subset expectation maximization (OSEM), OSEM + time of flight (TOF), OSEM + TOF + point spread function (PSF), and BPL. [18F]FDG parameters of maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume (MTV), total lesion glycolysis (TLG), and signal-to-background ratio (SBR) of these lesions were measured. Quantitative parameters between the different reconstruction algorithms were compared, and correlations between parameter variation and lesion size or the degree of [18F]FDG uptake were analyzed. RESULTS: After BPL reconstruction, SUVmax, SUVmean, and SBR were significantly increased, MTV was significantly decreased. The difference values of %ΔSUVmax, %ΔSUVmean, %ΔSBR, and the absolute value of %ΔMTV between BPL and OSEM + TOF were 40.00%, 38.50%, 33.60%, and 33.20%, respectively, which were significantly higher than those between BPL and OSEM + TOF + PSF. Similar results were observed in the comparison of OSEM and OSEM + TOF + PSF with BPL. The %ΔSUVmax, %ΔSUVmean, and %ΔSBR were all significantly negatively correlated with the size and degree of [18F]FDG uptake in the lesions, whereas significant positive correlations were observed for %ΔMTV and %ΔTLG. CONCLUSION: The BPL reconstruction algorithm significantly increased SUVmax, SUVmean, and SBR and decreased MTV of tumor lesions, especially in small or relatively hypometabolic lesions.

Blood prognostic predictors of treatment response for patients with papillary thyroid cancer.

BACKGROUND: Papillary thyroid cancer (PTC) is a very common malignant disease with high morbidity. We needed some pretreatment indicators to help us predict prognosis and guide treatment. We conducted a study about some pretreatment prognostic indicators. METHODS: This clinical study recruited 705 postoperative PTC patients (211 males, 494 females). Clinical data before radioactive iodine (RAI) treatment were collected. Patients' response to therapy were classified into two categories: 'Good Prognosis Group' (GPG) and 'Poor Prognosis Group' (PPG), according to '2015 American Thyroid Association Guidelines'. Differences of indicators between different prognosis groups were compared. Odds ratios (ORs) were calculated by univariate/multiple binary logistic regression models. Difference of body mass index (BMI) changes before and after RAI treatment between different prognosis groups was also compared. RESULTS: A total of 546 (77.45%) belonged to GPG, and 159 (22.55%) belonged to PPG. Platelet (PLT), neutrophil (NEUT), PLT subgroups, and combination of red blood cell distribution width (RDW) and BMI (COR-BMI) were different between two prognosis groups. The significance of the difference between the two groups of BMI disappeared after the Bonferroni correction. PLT and PLT subgroups had detrimental effects on the risk of PPG; T stage had a positive effect on the risk of PPG. PLT subgroup showed a detrimental effect on the risk of PPG when we included additional covariates. CONCLUSIONS: We found that lower pretreatment PLT levels may indicate a poor prognosis for PTC. The relationship between platelet-derived growth factor (PDGF) and radiation sensitivity may be the key to this association.

Knockdown of LINC02471 Inhibits Papillary Thyroid Carcinoma Cell Invasion and Metastasis by Targeting miR-375.

BACKGROUND: LncRNAs play important roles in papillary thyroid carcinoma (PTC). LINC02471 has been reported to be related to PTC prognosis. The current study aimed to investigate the effects of LINC02471 on human PTC cells. METHODS: Quantitative real-time polymerase chain reaction (qRT-PCR) was performed to examine LINC02471 expression in PTC tissues and cells and miR-375 expression in PTC cells. SiLINC02471, miR-375 mimic and miR-375 inhibitor were used for cell transfection. Cell proliferation, apoptosis, migration, and invasion were detected by performing Cell Counting Kit-8 (CCK-8), clone formation assay, flow cytometry, scratch assay, and transwell assay. Western blot was carried out to detect protein levels of E-cadherin, N-cadherin and Snail. The target gene for LINC02471 was verified by dual-luciferase reporter assay. RESULTS: LINC02471 was highly expressed in PTC tissues and cells. After silencing LINC02471, cell proliferation, migration and invasion were reduced, but cell apoptosis was increased. SiLINC02471 increased the expressions of E-cadherin and miR-375, and inhibited the expressions of N-Cadherin and Snail. LINC02471 directly targeted miR-375 in PTC cells. Overexpression of miR-375 inhibited the proliferation, migration, invasion of PTC cells and reduced the expressions of N-Cadherin and Snail but promoted the cell apoptosis and increased E-cadherin expression, while miR-375 inhibitor produced opposite effects to overexpressed miR-375. After inhibiting miR-375 expression, siLINC02471 reversed the effect of miR-375 inhibitor. CONCLUSION: LINC02471 could promote the development of PTC. Knocking down LINC02471 could inhibit invasion and metastasis and promote PTC cell apoptosis through directly targeting miR-375.

Diagnostic value of clinical parameters and parathyroid scintigraphy for asymptomatic primary hyperparathyroidism.

OBJECTIVE: The purpose of this study was to evaluate the diagnostic value of clinical parameters and parathyroid scintigraphy for asymptomatic primary hyperparathyroidism (aPHPT), including quantitative parameter of laboratory and semiquantitative parameters derived from technetium-99m- metoxyisobutylisonitrile (99mTc-MIBI) single photon emission computed tomography/computed tomography (SPECT/CT). SUBJECTS AND METHODS: Two hundred and fourteen patients who had been diagnosed as PHPT and underwent surgical treatment were enrolled in this study. All patients were divided into two groups: aPHPT and symptomatic PHPT (sPHPT). Dual tracer 99mTc pertechnetate/99mTc-MIBI, dual time point and tomography scintigraphy with 99mTc-MIBI SPECT/CT were performed. Clinical parameters included basic information, serum calcium (Ca), phosphorus (P), parathyroid hormone (PTH) and alkaline phosphatase (ALP) levels. Semiquantitative parameters of parathyroid scintigraphy included the average counts of early parathyroid (PT1), late parathyroid (PT2), early thyroid (T1) and late thyroid (T2), the ratio of PT1/ T1 (R1), the ratio of PT2/ T2 (R2), parathyroid washout (PTW=(PT1-PT2)/PT1) and retention index (RI=(R2-R1)/R1). P<0.05 was considered as statistically significant. RESULTS: A total of 167 aPHPT patients (46 males, 121 females) were studied. One hundred and seventy four One hundred and seventy four174 parathyroid glands were removed after operation: 146 (87.4%) lesions were adenoma, 12 (7.2%) lesions were hyperplasia and 1 (0.6%) lesion was adenocarcinoma. There were significant differences in previous history (P=0.000), echo of parathyroid (P=0.004), thyroid function (P=0.029), clinical course (Z=-3.422, P=0.001), 99mTc-pertechnetat thyroid uptake (TcTU) (Z=-2.126, P=0.033), serum Ca level (t=-2.926, P=0.004) and serum PTH level (Z=-3.028, P=0.002) between aPHPT and sPHPT. For patients with aPHPT, there were significant differences for serum Ca level (t=2.832, P=0.005), R2 (Z=-2.597, P= 0.009) and RI (Z=-2.100, P=0.036) between adenoma and hyperplasia, and serum Ca level in aPHPT patients with adenoma was significantly higher compared with patients with hyperplasia. The areas under the curve (AUC) of clinical course, TcTU, serum Ca and PTH levels were 0.662, 0.399, 0.642 and 0.645 respectively for differential diagnosis of aPHPT and sPHPT. The AUC of R2 and RI were 0.737 and 0.692 respectively for differential diagnosis of adenoma and hyperplasia in patients with aPHPT. The sensitivity, negative predictive value (NPV) and accuracy for diagnosing aPHPT combined 99mTc-MIBI SPECT/CT with ultrasound (US) were significantly higher than dual tracer, dual time point, 99mTc-MIBI SPECT/CT and US, which were 97.5%, 95.2% and 55.6% respectively. CONCLUSION: Laboratory inspection and semi-quantitative parameters of parathyroid scintigraphy had higher value for differential diagnoses of aPHPT and sPHPT, the same for adenoma and hyperplasia in patients with aPHPT. When combined 99mTc-MIBI SPECT/CT with US, the diagnostic efficiency would be significantly improved.

99mTcO4-/99mTc-MIBI dual-tracer scintigraphy for preoperative localization of parathyroid adenomas.

OBJECTIVE: To investigate the accuracy of dual-tracer scintigraphy for locating parathyroid adenomas in patients with primary hyperparathyroidism (PHPT). METHODS: We reviewed 268 patients with PHPT. All patients underwent technetium-99m pertechnetate (99mTcO4-) scintigraphy and technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) dual-tracer scintigraphy of the thyroid and parathyroid glands, respectively. 99mTcO4- planar scintigraphy was carried out initially followed by dual-phase 99mTc-MIBI single-photon emission computed tomography (SPECT)/CT the next day. The findings were combined and interpreted. Individual 99mTc-MIBI and dual-tracer scintigraphy were both analyzed. The sensitivity, specificity, and accuracy were determined in relation to surgical findings. The average interval between scan and surgery was 13 days. RESULTS: The positive and negative predictive values of 99mTc-MIBI SPECT/CT were 92.0% and 71.3%, respectively, and the sensitivity, specificity, and accuracy were 88.3%, 79.2%, and 85.8%, respectively. The positive and negative predictive values of dual-tracer scintigraphy were 96.3% and 82.3%, respectively, and the sensitivity, specificity, and accuracy were 92.9%, 90.3%, and 92.2%, respectively. Youden's index for dual-tracer scintigraphy and 99mTc-MIBI SPECT/CT were 0.83 and 0.63, respectively. CONCLUSIONS: These finding suggest that 99mTcO4- and 99mTc-MIBI dual-tracer scintigraphy is more accurate than other scintigraphy methods for detecting parathyroid adenoma, and may thus be the most suitable imaging technique in patients with PHPT.

Application of the alteration uptake ratio of 99mTc-MIBI scintigraphy for evaluating the efficacy of neoadjuvant chemotherapy in osteosarcoma patients.

BACKGROUND: We aimed to semi-quantitatively evaluate using technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) scintigraphy the efficacy of neoadjuvant chemotherapy in osteosarcoma (OS) patients. SUBJECTS AND METHODS: A hundred and two patients with OS were retrospectively included in this study. All of them underwent 99mTc-MIBI scintigraphy before and after neoadjuvant chemotherapy. Semi-quantitative parameters including the uptake ratio (UR) and alteration of uptake ratio (AUR) were calculated for each patient. According to tumor necrosis rate (TNR), patients were classified into three group: a) Poor response group (grade I, TNR: less than 50%), b) Partial response group (grade II, TNR: 50%-89%) and c) Good response group (grade III, TNR: greater than 90%). The linear regression analysis of the AUR versus TNR was carried out. RESULTS: Poor response, partial response and good response were found in 30, 52 and 20 patients, respectively. In the poor-response group the URpre and URpost were 1.68±0.44 and 1.83±0.71, respectively and the AUR was -0.02±0.33. In the partial-response group the URpre and URpost were 2.42±1.42 and 1.59±0.71, respectively and the AUR was 0.28±0.18. In the good-response group the URpre and URpost were 2.58±0.61 and 1.21±0.16, respectively and the AUR was 0.46±0.10. There was a statistically significant difference of the AUR between poor-response and partial-response groups (P<0.01) and also between the poor-response and good-response groups (P<0.01). The linear regression analysis of the AUR versus TNR which showed a significantly positive correlation (r=0.76). CONCLUSION: The AUR was significant after neoadjuvant chemotherapy in the partial-response group and in the good-response group. Furthermore, it exhibited a positive correlation with TNR. All results indicated that 99mTc-MIBI scintigraphy can be used to evaluate neoadjuvant chemotherapy for OS patients.

Comprehensive characterization of differentially expressed genes in thyroid cancer.

AIM: To explore the patterns of gene expression and functionally characterize the differentially expressed genes (DEGs) in thyroid cancer. METHODS: DEGs were determined between 57 paired thyroid cancer and noncancerous tissues using DESeq2. Subsequently, the main functions of the DEGs were studied by a variety of analyses. RESULTS: We identified a cohort of 752 upregulated and 309 downregulated DEGs in thyroid cancer. Several hub DEGs were found in the protein-protein interaction networks. We also revealed a set of DEGs that were dysmethylated, involved in copy number variations and associated with clinical features in thyroid cancer. CONCLUSION: These results provide some novel findings on DEGs in thyroid cancer, which will be useful to guide further investigation and target therapy for this disease. [Formula: see text].

Clinical value of radionuclide small intestine transit time measurement combined with lactulose hydrogen breath test for the diagnosis of bacterial overgrowth in irritable bowel syndrome.

OBJECTIVE: Small intestine bacterial overgrowth (SIBO) may be a pathogenetic factor for irritable bowel syndrome (IBS). This syndrome cannot be explained by structural abnormalities and has no specific diagnostic laboratory tests or biomarkers. We studied quantitatively and semi-quantitatively, using lactulose hydrogen breath test (LHBT), small intestinal transit time (SITT) (99m)technetium-diethylene triamine pentaacetic acid ((99m)Tc-DTPA) in order to examine the mobility of small intestine as an indication of bacterial overgrowth in patients. METHODS: Eighty nine consecutive patients who met Rome criteria for IBS were retrospectively studied. According to the diagnostic criteria, all patients were divided into two groups: the SIBO group and the non-SIBO group. The tracer was a mixture of 10g lactulose, 37MBq (99m)Tc-DTPA and 100mL water. The patient drank the whole mixture during 1min and the SITT study started immediately. The SITT and the LHBT followed every 15min for up to 3h after emptying the urine bladder. Spearman's rank correlation was applied to assess the correlation of oro-cecum transit time (OCTT) between imaging and LHBT. The semi-quantitative index between the SIBO group and the non-SIBO group was analyzed with Wilcoxon's rank sum test. If there was significant group difference, the receiver operating characteristic (ROC) curve was used. P<0.05 was considered significant. RESULTS: The median and inter-quartile range for OCTT for the LHBT (OCTT-L) for all patients was 90min and 60min, respectively, and 75min and 45min for OCTT for the SITT study (OCTT-i). There was positive correlation between OCTT-L and OCTT-i at the 0.05 level (R=0.290, P=0.000). There were no differences in OCTT-i and in the rate of radioactivity (counts of regions of interest ROI) over the abdomen between the SIBO group and the non-SIBO group (P=0.116 and 0.290). There were significant differences in the temporal association of the hydrogen (H2) value with OCTT-i (H2-i) and OCTT-L between the two groups (P=0.000 and 0.000). The areas under the curve (AUC) of H2-i and OCTT-L were 0.749 and 0.138 respectively. CONCLUSION: Small intestinal transit time study using a lactose hydrogen breath test and (99m)Tc-DTPA is a real-time test for small intestine bacteria overgrowth in IBS patients and can be used as an indicator of the disease.

[²°¹TI and (99m)Tc-MIBI scintigraphy in evaluation of neoadjuvant chemotherapy for osteosarcoma].

OBJECTIVE: To evaluate the application of ²°¹TI and (99m)Tc-MIBI scintigraphy in assessment of neoadjuvant chemotherapy for osteosarcoma. METHODS: Twenty-two patients with osteosarcoma underwent both ²°¹TI and (99m)Tc-MIBI scintigraphy. According to tumor necrosis rate (TNR), 22 patients were classified into three groups: Group 1(necrosis less than 50%), Group 2(50% ≊ 89% necrosis) and Group 3(necrosis greater than 90%). The uptake ratio(UR) was obtained in images before and after chemotherapy. The alteration ratio(AR) and tumor necrosis ratio (TNR) were calculated. RESULTS: In ²°¹Tl images,UR(pre) and UR(post) (mean ± s.d.) of Group 1 were 2.14 ± 0.67, 2.07 ± 0.71 (P>0.05); UR(pre) and UR(post)of Group 2 were 3.45 ± 1.57 and 2.02 ± 0.97 (P<0.01); UR(pre) and UR(post) of Group 3 were 3.57 ± 0.67 and 1.36 ± 0.20 (P<0.01). In (99m)Tc-MIBI images, UR(pre)and UR(post) of Group 1 were 1.66 ± 0.42 and 1.85 ± 0.70 (P>0.05); UR(pre) and UR(post) of Group 2 were 2.39 ± 1.41 and 1.68 ± 0.72 (P<0.05);UR(pre) and UR(post) of Group 3 were 2.56 ± 0.60 and 1.19 ± 0.14 (P<0.01). The AR value in (201)Tl scintigraphy was -0.03-0.72, the liner regression analysis of AR versus TNR showed a highly significant positive correlation (r=0.95). The AR value in (99m)Tc-MIBI scintigraphy was -1.21-0.64, the liner regression analysis of AR versus TNR showed a highly significant positive correlation (r=0.71). The liner regression analysis of AR in ²°¹TI scintigraphy versus AR in (99m)Tc-MIBI scintigraphy showed a highly significant positive correlation (r=0.70). CONCLUSION: The AR changes significantly after neoadjuvant chemotherapy and is positively correlated with TNR, which indicates that ²°¹TI- and (99m)Tc-MIBI scintigraphy can be used for evaluation of neoadjuvant chemotherapy.

SPECT imaging of dopamine transporters with (99m)Tc-TRODAT-1 in major depression and Parkinson's disease.

To investigate dopamine transporter in major depressive disorder and Parkinson's disease, the authors obtained single photon emission computed tomography (SPECT) brain images from 13 patients with major depression, 17 Parkinson's disease patients, and 10 healthy volunteers by using 99mTc-TRODAT-1. The authors found the 99mTc-TRODAT-1 radio signal in the striatum was reduced in the majority of patients with major depressive disorder, and this decrease was even more severe in patients with Parkinson's disease. The results support the hypothesis of dopamine hypofunction in major depressive disorder and suggest that deficient dopamine transporter may be involved in the etiology of severe major depressive disorder.

[Value of (99m)Tc-MIBI/(18)F-FDG-dual-isotope simultaneous acquisition in diagnosis and treatment of myocardial infarction].

OBJECTIVE: To investigate the value of(99m)Tc-MIBI/(18)F-FDG-dual-isotope simultaneous acquisition (DISA) in diagnosis and treatment of patients with myocardial infarction. METHODS: Sixty-three patients with myocardial infarction who underwent DISA before and after treatment were enrolled in the study. All cases were divided into subgroups based on different treatment and myocardial viability: Group A1 (n = 16) with coronary revascularization and viable myocardium, A2 (n = 9) same as A1 but no viable myocardium; B1 (n = 6) with coronary revascularization + stem cell transplantation and viable myocardium, B2 (n = 7) same as B1 but no vital myocardium; C1 (n = 8) with stem cell transplantation and viable myocardium, C2 (n = 17) same as C1 but on viable myocardium. The changes of uptake rate of (99m)Tc-MIBI/(18)F-FDG before and after treatment were analyzed with SPSS 13.0 software. RESULT: There were statistical significances in DF value of (99m)Tc-MIBI or (18)F-FDG imaging before and after treatment in all groups (P <0.05), except Group A2 (P>0.05). The improvement of blood perfusion and metabolism in cardiac survival groups was more marked than that in non-cardiac survival groups after treatment (P<0.05). Furthermore, Group B1 was superior to Groups A1 and C1; Group B2 was superior to Group A2 and Group C2 (P<0.05 or<0.01). CONCLUSION: (99m)Tc-MIBI/(18)F-FDG DISA can detect myocardial viability and is of value for patients with myocardial infarction to choose appropriate therapeutic strategies. The degree of cardiac improvement after treatment can be evaluated by DISA.