title: A comparison of Tl-201, Tc-99m sestamibi, and Tc-99m tetrofosmin myocardial perfusion scintigraphy in patients with mild to moderate coronary stenosis.
abstract: BACKGROUND
  Thallium 201, technetium 99m sestamibi (MIBI), and Tc-99m tetrofosmin differ in their myocardial uptake characteristics. This may make the technetium tracers less sensitive for detecting mild to moderate coronary stenosis.
  
  
  RESULTS
  We identified 163 patients with angiographic mild to moderate stenosis (50%-89%) and coexistent severe disease (88/163 patients) from a previous study of patients who received either thallium, MIBI, or tetrofosmin for myocardial perfusion scintigraphy. Summed segmental uptake scores were used to assess myocardial perfusion of territories supplied by the mildly to moderately stenotic vessels. Mean (+/- SD) summed stress uptake scores in the left anterior descending artery territory were 21.4 +/- 3.8, 21.6 +/- 4.2, and 22.1 +/- 2.3 for thallium, MIBI, and tetrofosmin, respectively (P = .7); mean summed difference uptake scores were 1.2 +/- 1.8, 1.1 +/- 1.9, and 1.0 +/- 1.1, respectively (P = .8). In the non-left anterior descending artery territory, mean summed stress uptake scores were 32.5 +/- 6.3, 34.0 +/- 6.3, and 34.5 +/- 4.7 for thallium, MIBI, and tetrofosmin, respectively (P = .4), whereas mean summed difference scores were 1.9 +/- 2.6, 1.7 +/- 2.2, and 1.7 +/- 2.3, respectively (P = .9).
  
  
  CONCLUSIONS
  There were no significant differences between the tracers for the summed uptake scores. This suggests that the 3 tracers are comparable in clinical practice for assessing the extent and severity of perfusion abnormalities arising from mild to moderate coronary artery stenosis, especially in the presence of coexistent severe disease.
authors.affiliation: National Heart and Lung Institute, Imperial College London, London, United Kingdom. e.reyes@rbh.nthames.nhs.uk
authors.forename: Eliana
authors.initials: E
authors.lastname: Reyes
authors.forename: Chee Y
authors.initials: CY
authors.lastname: Loong
authors.forename: Mark
authors.initials: M
authors.lastname: Harbinson
authors.forename: Shelley
authors.initials: S
authors.lastname: Rahman
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Prvulovich
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Ell
authors.forename: Constantinos
authors.initials: C
authors.lastname: Anagnostopoulos
authors.forename: S Richard
authors.initials: SR
authors.lastname: Underwood
mesh_terms: D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017256:Technetium Tc 99m Sestamibi; D013793:Thallium
chemical_list: D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C027549:thallium chloride; C078700:technetium tc-99m tetrofosmin; D017256:Technetium Tc 99m Sestamibi; D013793:Thallium