Head-to-head comparison between technetium-99m-sestamibi and thallium-201 tomographic imaging for the detection of coronary artery disease using combined dipyridamole-exercise stress.
OBJECTIVE
The purpose of this study was a head-to-head comparison of tomographic imaging (SPECT) with technetium-99m (Tc-99m)-sestamibi and thallium-201 (Tl-201) using dipyridamole-low-level bicycle exercise stress for the assessment of coronary artery disease.


METHODS
We studied 38 consecutive patients referred for the evaluation of chest pain who had undergone coronary angiography. The patients were randomly allocated to Tc-99m-sestamibi SPECT followed by Tl-201 SPECT or vice versa. The accuracy of both tracers in detecting significant coronary artery disease (> 50% luminal stenosis) was 87% (95% confidence interval 72-96%). Only two patients were classified differently by the two methods.


RESULTS
On a segmental basis, good agreement was found between Tc-99m-sestamibi and Tl-201 for both the localization and the nature of perfusion defects (reversible or persistent) identified (Cohen's kappa = 0.67).


CONCLUSIONS
No clinically relevant differences in diagnostic accuracy were demonstrated between Tc-99m-sestamibi and Tl-201 SPECT using combined dipyridamole-exercise stress for the evaluation of coronary artery disease.
Department of Cardiology, St. Antonius Hospital Nieuwegein, The Netherlands.
M J
MJ
Cramer
J F
JF
Verzijlbergen
E E
EE
Van der Wall
M G
MG
Niemeyer
A H
AH
Zwinderman
C A
CA
Ascoop
E J
EJ
Pauwels
D000368:Aged; D003327:Coronary Disease / Q000175:diagnosis*; D018592:Cross-Over Studies; D004176:Dipyridamole; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017256:Technetium Tc 99m Sestamibi; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D013794:Thallium Radioisotopes; D004176:Dipyridamole; D017256:Technetium Tc 99m Sestamibi