Detection of coronary artery disease by dynamic planar and single photon emission tomographic imaging with technetium-99m teboroxime.
To test the clinical significance of technetium-99m teboroxime regional myocardial clearance in the detection of coronary artery disease, 25 patients underwent dynamic planar or single-photon emission tomographic (SPET) myocardial imaging with 99mTc-teboroxime after exercise and again 2 h later at rest. All patients underwent both thallium-201 exercise and redistribution SPET and coronary arteriography. The early phases of exercise 99mTc-teboroxime myocardial clearance determined by dynamic planar imaging showed a significant difference between normal and post-stenotic myocardial regions (clearance rate constant k: 0.047 +/- 0.005 min-1 versus 0.034 +/- 0.003 min-1, P < 0.001). Reflecting this "differential clearance" between myocardial regions, an early redistribution-like phenomenon was observed in a significant number of myocardial segments by comparing serially acquired post-exercise 99mTc-teboroxime SPET images. These results indicated that the analysis of 99mTc-teboroxime myocardial clearance was of potential use in the detection of coronary artery disease, yielding additional information to that provided by the tracer distribution analysis. Although the early redistribution-like phenomenon of 99mTc-teboroxime could be the source of underestimation of ischaemia if acquisition of the initial post-exercise image were delayed, it could also prove useful in the early differentiation of ischaemia from scar because when the phenomenon was observed in delayed post-exercise images, the rest study could be omitted under some circumstances.
Yamagami
H
H
Department of Radiology, Osaka University Medical School, Japan.
Ishida
Y
Y
Morozumi
T
T
Kozuka
T
T
Nishimura
T
T
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; D010091:Oximes; D013794:Thallium Radioisotopes; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon
D015609:Organotechnetium Compounds; D010091:Oximes; D013794:Thallium Radioisotopes; C060156:technetium Tc 99m teboroxime