Reversible ischemia in severe stress Tc-99m-Sestamibi perfusion defects: Assessment with gated tomographic polar map Fourier amplitude and amplitude/perfusion ratio images and correlation with resting images

Journal Article · Sun May 01 04:00:00 EDT 1994 · Journal of Nuclear Medicine

OSTI ID:197935

Williams, K A; Taillon, L A ^[1]

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1. Univ. of Chicago, IL (United States)

Reversible ischemia in myocardial segments with severe hypoperfusion ({le}50% of normal activity) on stress Tc-99m-Sestamibi (MIBI) images was assessed with ECG-gated tomographic (GSPECT) indices of myocardial thickening, as reflected by an increase in regional count density during systole. GSPECT bullseye plots were generated for each of 8 frames acquired after stress MIBI injection in 39 patients with coronary artery disease and at least one severe perfusion defect on summed SPECT images. Using first harmonic Fourier amplitude (AMP) and AMP to perfusion ratio (APR) images, regional myocardial systolic thickening was assessed using a 5-segment model, scored 0 to 3, for absent, minimal, mildly reduced or normal thickening. These data were regionally compared with defect reversibility assessed using a separate-day or a preceding same-day resting MIBI injection images, in which these segments were scored from 0 to 3 for absent, minimal, partial or complete defect reversibility. Of 91 severe stress defects, 16 showed absent, 18 minimal, 43 partial, and 14 complete reversibility on resting images. Both AMP and APR scores were in statistically significant agreement (p=.0218 and .0006) with resting image reversibility grades, with 79% (p=.0324) and 86% (p=.0001) agreement on the presence of reversibility on resting imaging, respectively. AMP correctly identified 89% of the reversibility defects on rest images, while the APR identified 99% (p=.0248 vs. AMP). On analysis of segment scores, the AMP slightly underestimated the degree of rest image reversibility (p=.0235), while APR images indicated more reversibility thin did resting images (p=.0092). In conclusion, GSPECT MIBI bullseye Fourier AMP images correlate well with the pattern of reversibility on resting MIBI in severe stress perfusion defects. When indexed for the degree of hypoperfusion, the Fourier images depict a greater degree of defect reversibility than resting MIBI images.

• OSTI ID: 197935
• Report Number(s): CONF-940605--
• Journal Information: Journal of Nuclear Medicine, Journal Name: Journal of Nuclear Medicine Journal Issue: Suppl.5 Vol. 35; ISSN JNMEAQ; ISSN 0161-5505
• Country of Publication: United States
• Language: English

Related Subjects

55 BIOLOGY AND MEDICINE
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SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
TECHNETIUM 99