title: [99mTc-2-methoxy-isobutyl-isonitrile in the diagnosis of coronary heart disease: results of a multicenter study].
abstract: A total of 226 patients was studied in a phase-III multicenter trial to compare the results of stress/rest 99mTc-MIBI with 201TI scintigraphy and/or coronary arteriography. The evaluation of planar and SPECT imaging was based on a semiquantitative visual scoring. A congruent diagnosis was generated from all planar 201TI and 99mTc-MIBI scintigrams performed in 36 patients. In 62 of 63 patients, SPECT-studies with 99mTc-MIBI and 201TI led to an identical diagnosis. In one patient a positive result was obtained with 201TI-SPECT whereas 99mTc-MIBI was negative. Segmental agreement for 1509 SPECT segments was 85.7%, for 554 planar segments it was 86.6%. In comparison to coronary arteriography, performed in 180 patients, the overall sensitivity for the correct diagnosis of coronary artery disease (CAD) was 86% for planar MIBI scintigraphy or 92% for MIBI-SPECT. Overall specificity was 100% for planar imaging and 57% for SPECT. The low specificity of MIBI-SPECT was probably due to high prevalence of CAD in this study population. In a subgroup of 43 patients, who underwent coronary angiography, identical results were found with 99mTc-MIBI and 201TI. Only one patient showed a positive scintigraphic result with both 99mTc-MIBI and 201TI without angiographically proven stenosis greater than 50% or prior myocardial infarction. Vessel sensitivities in stenosed coronary arteries (greater than 50% stenosis) were 54% for the LAD and 87% for the RCX/RCA areas with MIBI-SPECT, or 51% or 79% for planar scintigraphy, respectively. Vessel specificities for SPECT were 65% in the LAD or 52% in the RCX/RCA, or 90% or 83% in planar imaging.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Abteilung für Nuklearmedizin, Philipps-Universität Marburg, Deutschland.
authors.forename: H
authors.initials: H
authors.lastname: Höffken
authors.forename: K
authors.initials: K
authors.lastname: Joseph
authors.forename: C
authors.initials: C
authors.lastname: Alexander
authors.forename: R
authors.initials: R
authors.lastname: Bauer
authors.forename: R
authors.initials: R
authors.lastname: Berberich
authors.forename: A
authors.initials: A
authors.lastname: Bischof-Delaloye
authors.forename: I
authors.initials: I
authors.lastname: Böttger
authors.forename: H
authors.initials: H
authors.lastname: Botsch
authors.forename: U
authors.initials: U
authors.lastname: Büll
authors.forename: B
authors.initials: B
authors.lastname: Delaloye
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009570:Nitriles; D015609:Organotechnetium Compounds; D017256:Technetium Tc 99m Sestamibi; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D009570:Nitriles; D015609:Organotechnetium Compounds; D013794:Thallium Radioisotopes; D017256:Technetium Tc 99m Sestamibi
vernacular_title: 99mTc-2-Methoxy-Isobutyl-Isonitril in der Diagnostik der koronaren Herzkrankheit: Ergebnisse einer Multizenterstudie.