Comparison of brain SPECT using 99mTc-bicisate (L,L-ECD) and [123I]IMP in cortical and subcortical strokes.
Single photon emission computed tomography (SPECT) using 99mTc-bicisate and N-isopropyl-p-[123I]iodoamphetamine ([123I]IMP) was compared in 25 patients suffering cerebral ischemia during the subacute phase (7-14 days) of stroke. Patients were classified as cortical strokes (15) and subcortical strokes (10) according to clinical and CT data. Images were analyzed by five independent blinded observers. Then, using a cross-matching method between normal and abnormal brain areas, we evaluated the sensitivity and specificity for 99mTc-bicisate and [123I]IMP and inter- and intraobserver reproducibility. A semiquantitative analysis was performed to compare abnormal hypoactive areas versus the corresponding contralateral areas for 99mTc-bicisate and [123I]IMP in the two patient groups. There was no significant difference for sensitivity and specificity between 99mTc-bicisate and [123I]IMP. Matching was approximately 90% in the two groups. The kappa-concordance index was satisfactory and slightly better for 99mTc-bicisate (0.485) than for [123I]IMP (0.435). Level of hypoactivity in the abnormal areas was significantly higher for 99mTc-bicisate (p < 0.03, n = 25) than for [123I]IMP, especially for cortical strokes. This comparative study demonstrates that 99mTc-bicisate is a very useful tracer for the detection of focal cerebral ischemia by SPECT during the subacute phase of stroke.
Moretti
J L
JL
Service de Médecine Nucléaire, CHU, Avicenne, Bobigny, France.
Defer
G
G
Tamgac
F
F
Weinmann
P
P
Belin
C
C
Cesaro
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000662:Amphetamines; D001921:Brain / Q000000981:diagnostic imaging*; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging*; D003545:Cysteine / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D020367:Iofetamine; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D012016:Reference Values; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
D000662:Amphetamines; D007457:Iodine Radioisotopes; D015609:Organotechnetium Compounds; D020367:Iofetamine; C059659:technetium Tc 99m bicisate; D003545:Cysteine