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European Heart Journal 1996 17(4):635-642;
Copyright © 1996 by the European Society of Cardiology.
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© 1996 The European Society of Cardiology

Tomographic myocardial imaging with technetium-99m tetrofosmin

Comparison with tetrofosmin and Thallium planar imaging and with angiography

Th. Benoit*, D. Vivegnis*, A. Lahiri{dagger}, R. Itti{ddagger}, S. Braat§ and P. Rigo*,

*University Hospital Liège, Belgium
{dagger}Northwick Park Hospital Harrow, U.K.
{ddagger}Cardiological Hospital Lyon, France
§Academic Hospital Maastricht, The Netherlands

Received 10 July 1995; accepted 7 August 1995.

Correspondence: Pierre Rigo, Division of Nuclear Medicine, University Hospital, Sart Tilman, B.35, B-4000 Liege 1, Belgium

Abstract

Technetium-99m tetrofosmin is a new myocardial imaging agent with improved handling and kinetic characteristics. The purpose of this study was to compare the ability of planar and SPECT Tc-99m tetrofosmin imaging with Thallium-201 planar data to detect coronary artery disease and individual vessel lesions (>5Q% diameter stenosis). Seventy-two patients with definite or suspected coronary artery disease were included. Sixty-three had angiographic evidence of coronary artery disease, among whom 42 had had a previous myocardial infarction, while 21 had not. The total number of diseased arteries was 111. Patients under went symptom-limited treadmill or bicycle exercise to simi lar endpoints. Thallium and tetrofosmin images were analysed separately by consensus reading. Interpretation was made for five standard anatomical regions (anterior, septal, inferior, lateral and apex), classified into four categories (normal, reversible, fixed and mixed defects). Sensitivity and specificity to detect coronary artery disease were 71% and 78% for Thallium-201 vs 68% and 78% for tetrofosmin by planar imaging, and 87% and 89% for tetrofosmin by SPECr. The improved sensitivity of SPECT was confirmed both in patients with and without previous myocardial infarction. The sensitivity to detect individual vessel lesions was improved by SPECT (59% tetrofosmin SPECT vs 50% thallium planar and 51% tetrofosmm planar). Individual vessel lesion detection by SPECT was 50% for the left anterior descending coronary artery, 42% for the left circumflex and 86% for the right coronary artery.

This study confirms the value of technetium-99m tetrofosmin as a myocardial imaging agent. Improvements in diagnosis and in evaluating extent of disease can be expected from using SPECT.

Key Words: Myocardial imaging • Tc-99m tetrofosmin • Thallium-201 • coronary artery disease


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