Improved diagnostic performance of thallium-201 myocardial perfusion scintigraphy in coronary artery disease: from planar to single photon emission computed tomography imaging.
BACKGROUND
This study was performed to compare Tl-201 myocardial perfusion single photon emission computed tomography (SPECT) with planar scintigraphy in the diagnosis of coronary artery disease (CAD).


METHODS
Retrospectively, 240 of 3262 patients, with exercise-redistribution Tl-201 myocardial perfusion scintigraphy performed between January 1990 and October 1997, were analyzed to compare Tl-201 scintigraphy and coronary arteriography. Within 30 days, all 240 patients underwent both coronary arteriography and exercise-redistribution Tl-201 myocardial perfusion scintigraphy with 86 SPECT and 154 planar images acquired.


RESULTS
The sensitivities of Tl-201 myocardial perfusion scintigraphy in individual coronary arteries including left anterior descending (LAD) artery, left circumflex (LCX) artery, and right coronary artery (RCA), were 77%/72%, 31%/30%, and 77%/50% in the SPECT/planar study groups, respectively. The sensitivities of CAD detection in patients with single-vessel, double-vessel, and triple-vessel diseases were 96%/82%, 91%/85%, and 96%/90% in the SPECT/planar study groups, respectively.


CONCLUSIONS
SPECT images provide greater advantages over planar images for better detection of the number, location, and extent of CAD. Cardiac SPECT does improve the accurate interpretation in abnormal Tl-201 distributions due to the higher contrast resolution and better separation of overlapping myocardial regions.
Tsai
Ming-Fong
MF
Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC. tsaimifo@cgmh.org.tw
Kao
Pan-Fu
PF
Tzen
Kai-Yuan
KY
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D013794:Thallium Radioisotopes