title: 99Tcm-SESTAMIBI for planar myocardial perfusion imaging; not as ideal as the physical properties.
abstract: 99Tcm-methoxyisobutyl isonitrile (Tc-SESTAMIBI) has recently been introduced as a new myocardial perfusion agent which exhibits ideal physical properties for imaging with the gamma camera. To assess the diagnostic accuracy of planar Tc-SESTAMIBI, myocardial perfusion imaging was performed in 60 consecutive patients at rest and during exercise. The results were compared with coronary angiographic findings, obtained within 3 months of the exercise test. Planar 201Tl images were also performed on the same day and to the same level of stress as the Tc-SESTAMIBI exercise. Exact segmental agreement between Tc-SESTAMIBI and 201Tl was 77%. Nineteen per cent of all 900 segments demonstrated ischaemia with Tc-SESTAMIBI and 20% with 201Tl. The overall sensitivity for detecting haemodynamically significant coronary artery disease with Tc-SESTAMIBI was 86% and specificity was 78%; with 201Tl the values were 89 and 78%, respectively (differences not significant). Vessel-specific comparative detection rates revealed no statistical significant differences between both radiopharmaceuticals. Intra-observer variability for Tc-SESTAMIBI images was 12% and for 201Tl it was 14%. Inter-observer variability for Tc-SESTAMIBI was 14% and for 201Tl 17%. Although the physical characteristics of Tc-SESTAMIBI allow crisp and clear high-count density imaging, no significant differences are found when planar images are compared with 201Tl and are well within observer variabilities.
authors.affiliation: Department of Nuclear Medicine, St Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: J F
authors.initials: JF
authors.lastname: Verzijlbergen
authors.forename: M J
authors.initials: MJ
authors.lastname: Cramer
authors.forename: M G
authors.initials: MG
authors.lastname: Niemeyer
authors.forename: C A
authors.initials: CA
authors.lastname: Ascoop
authors.forename: E E
authors.initials: EE
authors.lastname: Van der Wall
authors.forename: E K
authors.initials: EK
authors.lastname: Pauwels
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology*; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D013794:Thallium Radioisotopes
chemical_list: D015609:Organotechnetium Compounds; D013794:Thallium Radioisotopes; D017256:Technetium Tc 99m Sestamibi