Assessment of coronary artery disease using single-photon emission computed tomography with thallium-201 during adenosine-induced coronary hyperemia

Journal Article · Sat Jun 01 00:00:00 EDT 1991 · American Journal of Cardiology; (USA)

DOI:https://doi.org/10.1016/0002-9149(91)90925-B· OSTI ID:5760142

Iskandrian, A S; Heo, J; Nguyen, T; Beer, S G; Cave, V; Ogilby, J D; Untereker, W; Segal, B L ^[1]

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1. Presbyterian Medical Center, PA (USA)

Thallium-201 myocardial imaging during dipyridamole-induced coronary hyperemia has been an accepted method for diagnosing coronary artery disease (CAD) and risk stratification. Adenosine is a powerful short-acting coronary vasodilator. Initial results of thallium imaging during adenosine infusion have been encouraging. In 132 patients with CAD and in 16 patients with normal coronary angiograms, adenosine was given intravenously at a dose of 0.14 mg/kg/min for 6 minutes and thallium-201 was injected at 3 minutes. The thallium images using single-photon emission computed tomography were abnormal in 47 of the 54 patients (87%) with 1-vessel, in 34 of 37 patients (92%) with 2-vessel and in 40 of 41 patients (98%) with 3-vessel CAD. The sensitivity was 92% in the 132 patients with CAD (95% confidence intervals, 86 to 96%). In patients with normal coronary angiograms, 14 of 16 patients had normal thallium images (specificity, 88%; 95% confidence intervals, 59 to 100%). The results were very similar when subgroups of patients were analyzed: those without prior myocardial infarction, elderly patients and women. The nature of the perfusion defects (fixed or reversible) was assessed in relation to whether the 4-hour delayed images were obtained with or without the reinjection technique. In patients who underwent conventional delayed imaging, there were more fixed perfusion defects than in patients with reinjection delayed imaging (16 vs 0%, p less than 0.0001). The adverse effects were mild, transient and well tolerated. Thus, adenosine thallium tomographic imaging provides a high degree of accuracy in the diagnosis of CAD. The use of the reinjection technique enhances the ability to detect reversible defects.

• OSTI ID: 5760142
• Journal Information: American Journal of Cardiology; (USA), Vol. 67:15; ISSN 0002-9149
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
CARDIOVASCULAR DISEASES
DIAGNOSIS
MYOCARDIUM
SCINTISCANNING
SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
SENSITIVITY ANALYSIS
ADENOSINE
EXERCISE
PATIENTS
PERFUSED ORGANS
THALLIUM 201
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COUNTING TECHNIQUES
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ELECTRON CAPTURE RADIOISOTOPES
EMISSION COMPUTED TOMOGRAPHY
HEART
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MUSCLES
NUCLEI
NUCLEOSIDES
NUCLEOTIDES
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
ORGANS
RADIOISOTOPE SCANNING
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