title: Value and limitation of stress thallium-201 single photon emission computed tomography: comparison with nitrogen-13 ammonia positron tomography.
abstract: The diagnostic value of exercise 201Tl single photon emission computed tomography (SPECT) for assessing coronary artery disease (CAD) was comparatively evaluated with exercise [13N] ammonia positron emission tomography (PET). Fifty-one patients underwent both stress-delayed SPECT imaging using a rotational gamma camera and stress-rest PET imaging using a high resolution PET camera. Of 48 CAD patients, SPECT showed abnormal perfusion in 46 patients (96%), while PET detected perfusion abnormalities in 47 (98%). The sensitivity for detecting disease in individual coronary arteries (greater than 50% stenosis) was also similar for SPECT (81%) and PET (88%). When their interpretations were classified as normal, transient defect, and fixed defect in 765 myocardial segments, SPECT and PET findings were concordant in 606 segments (79%). However, 66 segments showed a fixed defect by SPECT but a transient defect by PET, whereas there were only nine segments showing a transient defect by SPECT and a fixed defect by PET. PET identified transient defects in 34% of the myocardial segments showing a fixed defect by SPECT. We conclude that both stress SPECT and PET showed high and similar sensitivities for detecting CAD and individual stenosed vessels. Since stress-delayed SPECT with single tracer injection detected fewer transient defects, it may underestimate the presence of myocardial ischemia, compared with high resolution PET imaging with two tracer injections.
authors.affiliation: Department of Nuclear Medicine & Radiology, Kyoto University School of Medicine, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Tamaki
authors.forename: Y
authors.initials: Y
authors.lastname: Yonekura
authors.forename: M
authors.initials: M
authors.lastname: Senda
authors.forename: K
authors.initials: K
authors.lastname: Yamashita
authors.forename: H
authors.initials: H
authors.lastname: Koide
authors.forename: H
authors.initials: H
authors.lastname: Saji
authors.forename: T
authors.initials: T
authors.lastname: Hashimoto
authors.forename: T
authors.initials: T
authors.lastname: Fudo
authors.forename: H
authors.initials: H
authors.lastname: Kambara
authors.forename: C
authors.initials: C
authors.lastname: Kawai
mesh_terms: D000328:Adult; D000368:Aged; D000641:Ammonia; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D006801:Humans; D008875:Middle Aged; D009590:Nitrogen Radioisotopes; D005082:Physical Exertion; D013794:Thallium Radioisotopes; D014055:Tomography, Emission-Computed
chemical_list: D009590:Nitrogen Radioisotopes; D013794:Thallium Radioisotopes; D000641:Ammonia