title: Myocardial kinetics of 99Tcm hexakis-(2-methoxy-isobutyl-isonitrile) (HMIBI) in patients with coronary heart disease: a comparative study versus 201Tl with SPECT.
abstract: In 15 patients with coronary heart disease, 74 MBq 201Tl (A) and 240 MBq 99Tcm HMIBI (B) were injected during exercise on separate days and SPECT imaging was applied. In (B) a consecutive second injection was given with an identical dose 3 h later (at rest) and net rest distribution was obtained from a subtraction technique. From polar, target-like ROIs, data were computed to compare regional vitality, wash-out and wash-out corrected redistribution. Myocardial wash-out, in contrast to 201Tl, was found to be 20% for 99Tcm independent of the regional myocardial state. Since no considerable redistribution occurred, myocardial distribution of 99Tcm HMIBI remained rather constant for 3 h, resulting in a maximum myocardium to lung ration of about 5. After the second injection, redistribution revealed the same results as in the 201Tl targets. From regional exercise to rest ratios a 'perfusion reserve' was determined which was 2.1 in normal and 1.3 in myocardial areas with defects. Myocardial defect uptake and defect size were nearly identical, yielding agreement in 97% of the myocardial segments. We conclude that 99Tcm HMIBI is a most powerful myocardial imaging agent. The final routine protocol, however, is as yet not established.
authors.affiliation: Department of Nuclear Medicine, Technical University of Aachen, Federal Republic of Germany.
authors.forename: H
authors.initials: H
authors.lastname: Stirner
authors.forename: U
authors.initials: U
authors.lastname: Buell
authors.forename: E
authors.initials: E
authors.lastname: Kleinhans
authors.forename: R
authors.initials: R
authors.lastname: Bares
authors.forename: W
authors.initials: W
authors.lastname: Grosse
mesh_terms: D003327:Coronary Disease / Q000000981:diagnostic imaging*; D006801:Humans; D009206:Myocardium / Q000378:metabolism*; D009570:Nitriles / Q000493:pharmacokinetics*; D009942:Organometallic Compounds / Q000493:pharmacokinetics*; D005082:Physical Exertion; D013667:Technetium / Q000493:pharmacokinetics*; D017256:Technetium Tc 99m Sestamibi; D013794:Thallium Radioisotopes / Q000493:pharmacokinetics*; D014055:Tomography, Emission-Computed
chemical_list: D009570:Nitriles; D009942:Organometallic Compounds; D013794:Thallium Radioisotopes; D013667:Technetium; D017256:Technetium Tc 99m Sestamibi