Myocardial Viability Assessment with Technetium-99m-Tetrofosmin and Thallium-201 Reinjection in Coronary Artery Disease

• Published in: The Journal of nuclear medicine (1978) Vol. 36; no. 11; pp. 1961 - 1967
• Main Authors: Matsunari, Ichiro, Fujino, Susumu, Taki, Junichi, Senma, Junji, Aoyama, Takahiko, Wakasugi, Takanobu, Hirai, Jun-ichi, Saga, Takashi, Ichiyanagi, Kenji, Hisada, Kinichi
• Format: Journal Article
• Language: English
• Published: United States Soc Nuclear Med 01.11.1995
• Subjects: Coronary Disease - diagnostic imaging; Exercise Test; Female; Heart - diagnostic imaging; Humans; Image Processing, Computer-Assisted; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Thallium Radioisotopes; Time Factors; Tomography, Emission-Computed, Single-Photon
• ISSN: 0161-5505; 1535-5667

Exercise-rest 99mTc-tetrofosmin myocardial perfusion images with a 2-day protocol was compared to exercise-redistribution-reinjection 201Tl images to assess the ability of 99mTc-tetrofosmin to detect viable myocardium. We studied 25 patients with coronary artery disease and regional or global left ventricular dysfunction. Myocardial SPECT images with 99mTc-tetrofosmin were obtained 10 min after injection during exercise and 1 and 3 hr after rest injection. Within 1 wk of the 99mTc-tetrofosmin study, exercise-redistribution-reinjection 201Tl SPECT imaging was performed. Visual analysis demonstrated concordance between 201Tl and 99mTc-tetrofosmin imaging for defect reversibility in 126 of 209 segments (60%), with initial defects on both exercise 201Tl and 99mTc-tetrofosmin images. In the remaining discordant 83 segments (40%), 73 (88%) appeared nonreversible on 99mTc-tetrofosmin imaging but were reversible on 201Tl imaging. On the basis of defect reversibility by visual analysis, exercise-rest 99mTc-tetrofosmin imaging underestimates myocardial viability compared to 201Tl reinjection imaging. The identification of viable myocardium with both 99mTc-tetrofosmin and 201Tl can be greatly enhanced to a similar degree if the severity of reduction in activity within nonreversible defects is considered. These two agents may provide comparable information about myocardial viability by quantitative analysis of defect severity.