Exercise thallium-201 scintigraphy in the diagnosis and prognosis of coronary artery disease.
OBJECTIVE
To determine the discriminant accuracy of exercise thallium-201 myocardial perfusion scintigraphy for the diagnosis and prognosis of patients with known or suspected coronary artery disease.


METHODS
A survey of the National Library of Medicine MEDLINE database.


METHODS
The key medical subject headings used were coronary disease, myocardial infarction, radionuclide imaging, and thallium. A total of 122 retrieved studies were considered relevant and were reviewed in depth.


METHODS
Only studies reporting both the sensitivity and specificity of thallium scintigraphy were analyzed.


RESULTS
Discriminant accuracy for diagnosis and prognosis was summarized in terms of pooled sensitivity and specificity.


CONCLUSIONS
Exercise thallium scintigraphy is useful in the noninvasive diagnosis of coronary artery disease, especially in patients with abnormal resting electrocardiograms, restricted exercise tolerance, and intermediate probability of having disease at the time of testing as well as of defining the prognosis of patients with known or suspected coronary artery disease, especially in those with previous myocardial infarction. Because of various shortcomings in the published record, however, the marginal discriminant accuracy and cost effectiveness of thallium scintigraphy compared with conventional clinical assessment and exercise electrocardiography remain controversial.
Kotler
T S
TS
Cedars-Sinai Medical Center, Los Angeles, California.
Diamond
G A
GA
D003327:Coronary Disease / Q000175:diagnosis / Q000000981:diagnostic imaging*; D005080:Exercise Test; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000000981:diagnostic imaging; D011379:Prognosis; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D013794:Thallium Radioisotopes / Q000009:adverse effects
D013794:Thallium Radioisotopes