Should coronary angiography be the gold standard. A study correlating thallium myocardial scintigraphy, translesional pressure gradient and percent stenosis

Conference · Wed May 01 00:00:00 EDT 1985 · J. Nucl. Med.; (United States)

OSTI ID:6760032

Fung, A Y; Krell, M; O'Neill, W W; Ackermann, R J; Buda, A J; Pitt, B; Juni, J

Coronary angiography provides anatomical information whereas thellium myocardial scintigraphy measures resistive tissue perfusion. Because of this fundamental difference. The authors question the validity of using coronary angiography as the gold standard to judge thellium myocardial scintigraphy. The authors studied 20 patients undergoing elective percutaneous coronary angioplasty who fulfilled the following criteria: (1) history of chest pain; (2) angiographically significant single vessel disease (>50% stenosis); (3) no prior myocardial infarction. All patients underwent maximal exercise thallium single photon emission computed tomography (T1-SPECT). Tl-SPECT was scored visually according to a 0 to 3 scale (0=absent uptake; 1=markedly decreased uptake; 2=minimally decreased uptake; 3=normal uptake). Translesional gradient and percent stenosis were measured before and after angioplasty. The authors found that significant linear relationship exists between percent stenosis and Tl-SPECT (p<0.01) as well as between translesional pressure gradient and T1-SPECT (p<0.01). The variability of percent stenosis is significantly greater than the variability of translesional pressure gradient across the T1-SPECT scores (p<0.01). In addition, 2 patients with ''false negative'' T1-SPECT with >50% angiographic stenosis had negligible translesional pressure gradient. Thus, T1-SPECT provides functional information which predicts translesional pressure gradient. Percent stenosis provides anatomic information but does not adequately measure functional significance. The authors suggest that angiographic percent stenosis may not be a satisfactory gold standard to evaluate thallium scintigraphy.

• Research Organization: Univ. of Michigan Hospital, Ann Arbor, MI
• OSTI ID: 6760032
• Report Number(s): CONF-850611-
• Journal Information: J. Nucl. Med.; (United States), Journal Name: J. Nucl. Med.; (United States) Vol. 26:5; ISSN JNMEA
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
ANATOMY
ARTERIES
BENCHMARKS
BETA DECAY RADIOISOTOPES
BIOMEDICAL RADIOGRAPHY
BLOOD FLOW
BLOOD VESSELS
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COMPARATIVE EVALUATIONS
CORONARIES
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DETECTION
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
HEART
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MEDICINE
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PERFORMANCE
PHYSIOLOGY
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIOLOGY
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
THALLIUM 201
THALLIUM ISOTOPES