Technetium-99m-sestamibi SPECT to detect restenosis after successful percutaneous coronary angioplasty.
This study evaluated the accuracy of 99mTc SPECT in predicting restenosis after primary successful PTCA.


METHODS
Thirty-seven patients with equivocal symptom-limited exercise stress testing were evaluated. All patients underwent separate day exercise-rest 99mTc-sestamibi SPECT. The perfusion studies were evaluated using three different methods of analysis: visual inspection, semiquantitative and quantitative polar map analysis. The perfusion studies were interpreted in absence of a pre-PTCA scan. All patients underwent a control coronary angiography within 1 mo.


RESULTS
Sensitivity and specificity of 99mTc-sestamibi SPECT in predicting restenosis were 87.5-78%, 50-65% and 75-74% for visual inspection, semiquantitative and quantitative polar map analysis, respectively. Sensitivity and specificity related to the vascular territories were: LAD territory 93-73% (qualitative analysis), 53-60% (semiquantitative analysis), 80-67% (quantitative analysis); LCX territory 83-100% (qualitative analysis); and 33-100% (semiquantitative analysis), 67-100% (quantitative analysis); and RCA territory 67-80% (qualitative analysis), 67-60% (semiquantitative analysis), 67-80% (quantitative analysis).


CONCLUSIONS
These data suggest that 99mTc-sestamibi SPECT is a useful noninvasive tool in the follow-up evaluation of patients who have undergone angiographically successful coronary angioplasty even in the absence of a pre-PTCA perfusion study.
Milan
E
E
Nuclear Medicine and Cardiology Departments, Civic Hospital and University of Brescia, Italy.
Zoccarato
O
O
Terzi
A
A
Ettori
F
F
Leonzi
O
O
Niccoli
L
L
Giubbini
R
R
D015906:Angioplasty, Balloon, Coronary; D016022:Case-Control Studies; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D004562:Electrocardiography; D005069:Evaluation Studies as Topic; D005080:Exercise Test; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012008:Recurrence; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon
D017256:Technetium Tc 99m Sestamibi