Myocardial perfusion imaging with technetium-99m-Tc NOET: comparison with thallium-201 and coronary angiography.
We compared TcN-NOET [bis(N-ethoxy, N-ethyl dithiocarbamato)nitrido 99mTc] and 201Tl images to estimate the utility of this compound in the detection of coronary artery disease (CAD).


METHODS
Twenty-five patients undergoing cardiac catheterization had stress-redistribution-reinjection 201Tl SPECT imaging, stress-delayed (2, 4 and 6 hr postinjection) and rest-delayed (4 hr postinjection) TcN-NOET SPECT imaging.


RESULTS
Nineteen patients had coronary stenosis > or = 50% and six were normal. Stress TcN-NOET and 201Tl imaging were concordant for the presence of CAD in 22/25 patients (88%, kappa = 0.76 +/- 0.20). The overall sensitivity of TcN-NOET SPECT imaging was 74% (14/19 patients) and 68% (13/19 patients) for 201Tl SPECT imaging. The specificity was 100% (6/6 patients) for both techniques. The overall agreement of TcN-NOET and 201Tl for the presence of disease in individual coronary arteries was 96% (72/75 arteries, kappa = 0.92 +/- 0.16). Segmental analysis of stress images showed a concordance in 211/225 segments (94%, kappa = 0.82 +/- 0.09). Comparison of the 4-hr images showed a concordance between 201Tl and TcN-NOET in 21/23 patients. Following TcN-NOET injection at rest, seven patients had a defect on the initial images, which had normalized 4 hr postinjection in four patients (57%).


CONCLUSIONS
Perfusion imaging with TcN-NOET and 201Tl gives comparable diagnostic information in patients undergoing exercise testing for assessment of CAD. Because of the normalization of myocardial activity 4 hr after injection in some patients, we conclude that TcN-NOET is a potential technetium compound equivalent to 201Tl.
Fagret
D
D
Service de Médecine Nucléaire, CHU de Nancy-Brabois, France.
Marie
P Y
PY
Brunotte
F
F
Giganti
M
M
Le Guludec
D
D
Bertrand
A
A
Wolf
J E
JE
Piffanelli
A
A
Chossat
F
F
Bekhechi
D
D
D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013794:Thallium Radioisotopes; D013859:Thiocarbamates
D015609:Organotechnetium Compounds; D013794:Thallium Radioisotopes; D013859:Thiocarbamates; C093922:technetium Tc 99m, bis(N-ethoxy-N-ethyldithiocarbamato)nitrido-