Comparison of SPECT using technetium-99m agents and thallium-201 and PET for the assessment of myocardial perfusion and viability

Journal Article · Tue Oct 16 00:00:00 EDT 1990 · American Journal of Cardiology; (USA)

DOI:https://doi.org/10.1016/0002-9149(90)90616-9· OSTI ID:6323407

Berman, D S; Kiat, H; Van Train, K F; Friedman, J; Garcia, E V; Maddahi, J ^[1]

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1. Cedars-Sinai Medical Center, Los Angeles CA (USA)

This report reviews the applications of tomographic imaging with current and new tracers in assessing myocardial perfusion and viability. Multiple studies with thallium-201 (TI-201) single photon emission computed tomography (SPECT) imaging for the detection of coronary artery disease (CAD) have demonstrated high sensitivity, high rates of normalcy and high reproducibility. In assessing viability, fixed defects are frequently detected in viable zones in 4-hour studies with TI-201 imaging. Redistribution imaging performed 18 to 72 hours after injection or reinjection of TI-201 before 4-hour redistribution imaging has been shown to improve accuracy of viability assessment. TI-201 SPECT studies are limited by the suboptimal physical properties of TI-201, which result in variable image quality. The 2 new technetium-99m (Tc-99m) - labeled myocardial perfusion tracers offer the ability to inject much higher amounts of radioactivity, making it possible to assess ventricular function as well as myocardial perfusion from the same injection of radiotracer. Tc-99m sestamibi has very slow myocardial clearance, which allows for prolonged imaging time and results in image quality superior to that obtained with TI-201 and Tc-99m teboroxime. The combination of minimal redistribution of Tc-99m sestamibi and high count rates makes gated SPECT imaging feasible, and also permits assessment of patients with acute ischemic syndromes by uncoupling the time of injection from the time of imaging. The combination of high image quality and first-pass exercise capabilities may lead to a choice of this agent over TI-201 for assessment of chronic CAD.(ABSTRACT TRUNCATED AT 250 WORDS)

• OSTI ID: 6323407
• Journal Information: American Journal of Cardiology; (USA), Vol. 66:13; ISSN 0002-9149
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARDIOVASCULAR DISEASES
DIAGNOSIS
MYOCARDIUM
IMAGE PROCESSING
RADIOPHARMACEUTICALS
COMPARATIVE EVALUATIONS
ISOMERIC NUCLEI
PATIENTS
SENSITIVITY ANALYSIS
SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
SPECIFICITY
TECHNETIUM 99
THALLIUM 201
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR SYSTEM
COMPUTERIZED TOMOGRAPHY
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DISEASES
DRUGS
ELECTRON CAPTURE RADIOISOTOPES
EMISSION COMPUTED TOMOGRAPHY
HEART
HEAVY NUCLEI
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LABELLED COMPOUNDS
MUSCLES
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PROCESSING
RADIOISOTOPES
SECONDS LIVING RADIOISOTOPES
TECHNETIUM ISOTOPES
THALLIUM ISOTOPES
TOMOGRAPHY
YEARS LIVING RADIOISOTOPES
550601* - Medicine- Unsealed Radionuclides in Diagnostics