Improved noninvasive assessment of coronary artery disease by quantitative analysis of regional stress myocardial distribution and washout of thallium-201

Journal Article · Sat Oct 31 23:00:00 EST 1981 · Circulation; (United States)

DOI:https://doi.org/10.1161/01.CIR.64.5.924· OSTI ID:5714580

Maddahi, J ^[1]; Garcia, E V; Berman, D S; Waxman, A; Swan, H J.C.; Forrester, J

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1. Cedars-Sinai Medical Center, Los Angeles, CA

Visual interpretation of stress-redistribution thallium-201 (/sup 201/Tl) scintigrams is subject to observer variability and is suboptimal for evaluation of extent of coronary artery disease (CAD). An objective, computerized technique has been developed that quantitatively expresses the relative space-time myocardial distribution of /sup 201/Tl. Multiple-view, maximum-count circumferential profiles for stress myocardial distribution of /sup 201/Tl and segmental percent washout were analyzed in a pilot group of 31 normal subjects and 20 patients with CAD to develop quantitative criteria for abnormality. Subsequently, quantitative analysis was applied prospectively to a group of 22 normal subjects and 45 CAD patients and compared with visual interpretation of scintigrams for detection and evaluation of CAD. The sensitivity and specificity of the quantitative technique (93% and 91%, respectively) were not significantly different from those of the visual method (91% and 86%). The quantitative analysis significantly (p < 0.05) increased the sensitivity of /sup 201/Tl imaging over the visual method in the left anterior descending artery (from 56% to 80%), left circumflex artery (from 34% to 63%) and right coronary artery (from 65% to 94%) without significant loss of specificity. Using quantitative analysis, sensitivity for detection of deseased vessels did not diminish as the number of vessels involved increased, as it did with visual interpretations. In patients with one-vessel disease, 86% of the lesions were detected by both techniques; however, in patients with three-vessel disease, quantitative analysis detected 83% of the lesions, while the sensitivity was only 53% for the visual method. Seventy percent of the coronary arteries with moderate (50%-75%)

• OSTI ID: 5714580
• Journal Information: Circulation; (United States), Journal Name: Circulation; (United States) Vol. 64:5; ISSN CIRCA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COMPARATIVE EVALUATIONS
COMPUTER CALCULATIONS
COUNTING TECHNIQUES
DATA
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
EVALUATED DATA
EXPERIMENTAL DATA
HEART
HEAVY NUCLEI
INFORMATION
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MEASURING METHODS
MUSCLES
MYOCARDIUM
NUCLEI
NUMERICAL DATA
ODD-EVEN NUCLEI
ORGANS
PRECIPITATION SCAVENGING
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIONUCLIDE KINETICS
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
SENSITIVITY ANALYSIS
SEPARATION PROCESSES
THALLIUM 201
THALLIUM ISOTOPES
UPTAKE
WASHOUT