title: Usefulness of rapid low-dose/high-dose 1-day 99mTc-sestamibi ECG-gated myocardial perfusion single-photon emission computed tomography.
abstract: BACKGROUND
  The clinical usefulness of a rapid rest low-dose/stress high-dose (dose ratio =1:5) (99m)Tc-sestamibi myocardial perfusion single-photon emission computed tomography (SPECT) protocol for the detection of coronary artery disease was evaluated.
  
  
  RESULTS
  In 89 patients, rest images were obtained immediately after the injection of (99m)Tc-sestamibi (256.1+/-28.4 MBq) followed by drinking water (400 ml). Exercise or vasodilator stress test was performed immediately after the completion of rest imaging with the injection of (99m)Tc-sestamibi (1312.3 +/-167.6 MBq). Prior to the post-stress imaging, patients were asked again to drink water (400 ml) in order to eliminate subdiaphragmatic tracer activity. The myocardial count ratio (stress/rest) of (99m)Tc-sestamibi was calculated. Image quality was scored using a 4-point scale system (4= excellent, 3= good, 2= poor, 1= unacceptable). Coronary angiography was performed in 56 patients within 1 month of the SPECT scan. All patients successfully performed the protocol and total examination time was 108+/-7 min. The myocardial count ratio of (99m)Tc-sestamibi was always greater than 6. The image quality was satisfactory both at rest (3.4+/-0.9) and after stress (3.9+/-0.2). The sensitivity and specificity to detect coronary artery stenosis >50% was 84% and 97%, respectively.
  
  
  CONCLUSIONS
  This rapid one-day (99m)Tc-sestamibi protocol provides adequate image quality and diagnostic accuracy for detecting coronary artery disease.
authors.affiliation: Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Matsumoto
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Sato
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Shunichi
authors.initials: S
authors.lastname: Yoda
authors.forename: Taeko
authors.initials: T
authors.lastname: Kunimasa
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kato
authors.forename: Futoshi
authors.initials: F
authors.lastname: Tadehara
authors.forename: Howard C
authors.initials: HC
authors.lastname: Lewin
authors.forename: Mark C
authors.initials: MC
authors.lastname: Hyun
authors.forename: Satoshi
authors.initials: S
authors.lastname: Saito
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003326:Coronary Circulation; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017256:Technetium Tc 99m Sestamibi / Q000008:administration & dosage*; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D017256:Technetium Tc 99m Sestamibi