Value and Limitation of Stress Thallium-201 Single Photon Emission Computed Tomography: Comparison with Nitrogen-13 Ammonia Positron Tomography

• Published in: The Journal of nuclear medicine (1978) Vol. 29; no. 7; pp. 1181 - 1188
• Main Authors: Tamaki, Nagara, Yonekura, Yoshiharu, Senda, Michio, Yamashita, Keiji, Koide, Harutoshi, Saji, Hideo, Hashimoto, Tetsuo, Fudo, Tetsuro, Kambara, Hirofumi, Kawai, Chuichi, Konishi, Junji
• Format: Journal Article
• Language: English
• Published: United States Soc Nuclear Med 01.07.1988
• Subjects: Adult; Aged; Ammonia; Coronary Disease - diagnostic imaging; Humans; Middle Aged; Nitrogen Radioisotopes; Physical Exertion; Thallium Radioisotopes; Tomography, Emission-Computed
• ISSN: 0161-5505; 1535-5667

The diagnostic value of exercise 201Tl single photon emission computed tomography (SPECT) for assessing coronary artery disease (CAD) was comparatively evaluated with exercise [13N] ammonia positron emission tomography (PET). Fifty-one patients underwent both stress-delayed SPECT imaging using a rotational gamma camera and stress-rest PET imaging using a high resolution PET camera. Of 48 CAD patients, SPECT showed abnormal perfusion in 46 patients (96%), while PET detected perfusion abnormalities in 47 (98%). The sensitivity for detecting disease in individual coronary arteries (greater than 50% stenosis) was also similar for SPECT (81%) and PET (88%). When their interpretations were classified as normal, transient defect, and fixed defect in 765 myocardial segments, SPECT and PET findings were concordant in 606 segments (79%). However, 66 segments showed a fixed defect by SPECT but a transient defect by PET, whereas there were only nine segments showing a transient defect by SPECT and a fixed defect by PET. PET identified transient defects in 34% of the myocardial segments showing a fixed defect by SPECT. We conclude that both stress SPECT and PET showed high and similar sensitivities for detecting CAD and individual stenosed vessels. Since stress-delayed SPECT with single tracer injection detected fewer transient defects, it may underestimate the presence of myocardial ischemia, compared with high resolution PET imaging with two tracer injections.