Clinical evaluation of four study protocols with 99mTc-methoxyisobutylisonitrile and SPECT for detecting diseased coronary vessels.
Different techniques have been suggested for coronary artery disease (CAD) detection with single-photon emission computed tomography (SPECT) and 99mTc-methoxyisobutylisonitrile (99mTc-MIBI). We evaluated four protocols employing myocardial SPECT with 99mTc-MIBI in separate groups of patients. The first involved stress and rest studies performed on separate days, whereas the other three involved "same day" studies. Group 1 (n = 23) was examined in separate sessions, after ergometric exercise and at rest. Group 2 (n = 24) was first injected after dipyridamole infusion, then injected again at rest after completion of the stress study. Group 3 (n = 24) was first injected at rest and imaged one hour later. Afterwards an ergometric stress was performed, with injection at peak exercise. The inverse sequence was adopted for group 4 (n = 24). All patients underwent coronary angiography. For all groups and vessels, the sensitivity and specificity for diseased coronary artery identification were not statistically different. Studies using the new myocardial perfusion tracer 99mTc-MIBI may therefore be completed on the same day or on separate days according to laboratory and patient needs. Dipyridamole iv infusion proved to be as effective as ergometric exercise for diseased coronary artery identification.
Department of Nuclear Medicine, S. Orsola-Malpighi Policlinic Hospital, Bologna, Italy.
M
M
Dondi
F
F
Tartagni
S
S
Coccolini
M
M
Levorato
L
L
Maiello
P
P
Antonioli
F
F
Fallani
C
C
Corbelli
G
G
Berti
N
N
Monetti
D002985:Clinical Protocols; D003287:Contrast Media; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D004176:Dipyridamole; D005069:Evaluation Studies as Topic; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009570:Nitriles; D015609:Organotechnetium Compounds; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
D003287:Contrast Media; D009570:Nitriles; D015609:Organotechnetium Compounds; D004176:Dipyridamole; D017256:Technetium Tc 99m Sestamibi