title: Defect reversibility using thallium-201 reinjection. Comparison of stress-redistribution-reinjection with stress-immediate reinjection.
abstract: Immediate poststress thallium-201 reinjection followed by imaging one hour later has been proposed as an alternative reinjection protocol. This procedure is patient-convenient and time-saving as it shortens the investigation time to maximally 2.5 hours. The efficacy of the immediate thallium-201 reinjection protocol was assessed in 305 patients with stress perfusion defects in whom we compared the scintigraphic findings of 210 consecutive patients who underwent the standard thallium-201 stress/redistribution/reinjection protocol (Group I), with 95 consecutive patients who subsequently underwent the thallium-201 stress/immediate reinjection protocol (Group II). In all patients three-view planar images were visually and quantitatively analyzed. In Group I, defect reversibility was observed in 433 of 622 (70%) stress perfusion defects compared to 220 of 320 (69%) segments in Group II (p = NS). With respect to Q-wave related segments, defect reversibility was seen in 102 of 172 (59%) segments in Group I compared to 34 of 63 (54%) in Group II (p = NS). Based on defect reversibility, the diagnosis of myocardial ischemia was made in 184 of 210 (88%) patients Group I compared to 86 of 95 (91%) patients in Group II (p = NS). These findings indicate that immediate thallium-201 reinjection imaging provides at least similar data on defect reversibility as the standard thallium-201 stress/redistribution/reinjection approach. In practical terms, the stress/immediate reinjection approach seems advantageous as it reduces imaging time, enhances patient throughout and can be considered as one comprehensive imaging procedure.
authors.affiliation: Department of Diagnostic Radiology and Nuclear Medicine, University Hospital, Leiden, The Netherlands.
authors.forename: B L
authors.initials: BL
authors.lastname: van Eck-Smit
authors.forename: A F
authors.initials: AF
authors.lastname: Kuijper
authors.forename: A H
authors.initials: AH
authors.lastname: Zwinderman
authors.forename: A V
authors.initials: AV
authors.lastname: Bruschke
authors.forename: E K
authors.initials: EK
authors.lastname: Pauwels
authors.forename: E E
authors.initials: EE
authors.lastname: van der Wall
mesh_terms: D016022:Case-Control Studies; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D013794:Thallium Radioisotopes / Q000008:administration & dosage; D013997:Time Factors
chemical_list: D013794:Thallium Radioisotopes