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Nuklearmedizin 1994; 33(02): 78-83
DOI: 10.1055/s-0038-1629683
Original Article
Schattauer GmbH

Dual-Isotope SPET201T1 Rest/99mTc-MIBI Stress: One-Day Protocol for Pre-Operative Myocardial Imaging?

A. Fikrle
1   From the Dept. of Nuclear Medicine, University of Berne/Inselspital, Berne, Switzerland
,
H. Rösler
1   From the Dept. of Nuclear Medicine, University of Berne/Inselspital, Berne, Switzerland
,
E. P. Ritter
1   From the Dept. of Nuclear Medicine, University of Berne/Inselspital, Berne, Switzerland
,
D. Lüscher
1   From the Dept. of Nuclear Medicine, University of Berne/Inselspital, Berne, Switzerland
,
H. Ledermann
1   From the Dept. of Nuclear Medicine, University of Berne/Inselspital, Berne, Switzerland
,
Th. Berthold
1   From the Dept. of Nuclear Medicine, University of Berne/Inselspital, Berne, Switzerland
› Author Affiliations
Further Information

Publication History

Received: 13 December 1993



Publication Date:
05 February 2018 (online)

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Summary

We compared the results of a rest 201TI/stress 99mTc-MIBI protocol, both by means of separate single isotope and simultaneous dual isotope acquisition, with a standard stress/rest 99mTc-MIBI 2-day protocol in 11 patients with low probability of CAD and 14 patients with chronic CAD. In patients with CAD 406 segments (sgs) were analysed. In the standard protocol 119sgs were classified as pathological of which 50.4% were fixed and 49.6% reversible defects. With the MIBI-stress/TI-rest single 33% of 119 pathological sgs were fixed and 67% reversible defects. With the MIBI-stress/TI-rest dual only 20% were fixed and 80% reversible defects. The reversibility of 59 MIBI-stress/ MIBI-rest reversible defects was quantified: MIBI-stress/MIBI-rest 35 ± 16% MIBI-stressl-rest single 50 ± 26% and MIBI-stress/TI-rest dual 48 ± 22%. The results of 99mTc-MIBI rest and 201TI rest studies in patients with chronic CAD are not the same. Dual-isotope 1-day 201TI-rest/99mTc-MIBI-stress SPET data, acquired separately, may give fast and complete information on myocardial perfusion at stress and rest, respectively, and on myocardial viability.

Zusammenfassung

Wir haben die Ergebnisse eines Eintags-Protokolls mit 201TI in Ruhe und 99mTc-MIBI unter Belastung - jeweils nach Ein- oder Zweikanal-Akquisition - mit einem Standard-Vorgehen über 2 Tage (Belastung und Ruhe mit MIBI) bei 11 Patienten mit niedriger KHK-Wahrscheinlichkeit und 14 mit chronischer KHK verglichen. Unter 406 sgs bei Patienten mit KHK waren in MIBI-Belastung/MIBI-Ruhe 119 sgs pathologisch, davon 50,4% mit fixem und 49,6% mit reversiblem Defekt. Dagegen fanden sich mit MIBI-Belastung/TI-Ruhe (single) jeweils 33% und 67%, in dualer Akquisition sogar nur 20% fixe, aber 80% reversible Defekte. Das Ausmaß der Umverteilung (59 reversible Defekte MIBI-Belastung/MIBI-Ruhe) wurde quantifiziert und betrug (in %) für MIBI-Belastung/MIBI-Ruhe 35 ± 16, für MIBI-BelastungATI-Ruhe (single) 50 ± 26 und (dual) 48 ± 22. Die Ergebnisse der Ruhe-Untersuchungen sind bei chronischer KHK nicht identisch mit 99mTc-MIBI und 201TI. Das 1-Tag-Protokoll 201TI in Ruhe und 99mTc-MIBI unter Belastung gibt, wenn in separaten Photo-Peaks gemessen werden, komplette Information über die myokardiale Durchblutung in Ruhe bzw. unter Belastung und über die myokardiale Viabilität.

Key words

Myocardial perfusion - myocardial viability - SPET

Schlüsselwörter

Myokardiale Durchblutung - myokardiale Viabilität - SPET
 

  • REFERENCES

  • 1 Althoefer C, Kaiser HJ, Dorr R. et al. Fluorine-18 deoxyglucose PET for assessment of viable myocardium in perfusion defects in 99mTc-MIBI SPET: a comparative study in patients with coronary artery disease. Eur J Nucl Med 1992; 19: 334-42.
    PubMedSearch in Google Scholar
  • 2 Berman D, Friedman J, Kial H. et al. Separate acquisition dual isotope myocardial perfusion SPECT: A practical approach to 99mTc sestamibi imaging. Circul 1991; 84 SupplII 11/314.
    Search in Google Scholar
  • 3 Berman DS, Kial H, van Train K. et al. Technetium-99m sestamibi in the assessment of chronic coronary artery disease. Scm Nucl Med 1991; 21: 190-212.
    Search in Google Scholar
  • 4 Bonow RO, Dilsizian V, Cuocolo A. et al. Identification of viable myocardium in patients with chronic coronary artery disease and left ventricular dysfunction. Comparison of thallium scintigraphy with reinjection and PET imaging with F-18 fluorodeoxyglu-cose. Circulation 1991; 77: 491-8.
    Search in Google Scholar
  • 5 Braunwald E, Rutherford JD. Reversible ischemic left ventricular dysfunction: evidence for “hibernating” myocardium. J Am Coll Cardiol 1986; 8: 1467-70.
    CrossrefPubMedSearch in Google Scholar
  • 6 Buell U, Althoefer C. Die 201T1-Myokard-szintigraphie (1974-1992): Vom Perfusionsdefekt zum Vitalitatsnachweis. Nucl-Med 1993; 32: 1-5.
    Search in Google Scholar
  • 7 Cuocolo A, Pace L, Ricciardelli B. et al. Identification of viable myocardium in patients with chronic coronary artery disease: comparison of thallium-201 scintigraphy with reinjection and technetium-99m-me-thoxy-isobuthyl-isonitrile. J Nucl Med 1992; 33: 505-11.
    PubMedSearch in Google Scholar
  • 8 De Vito RP, Hamill JJ. Determination of weighting functions for energy-weighted acquisition. J Nucl Med 1991; 32: 343.
    PubMedSearch in Google Scholar
  • 9 Dilsizian V, Rocco TR, Frccdman NMT, Leon MB, Bonow RO. Enhanced detection of ischemic but viable myocardium by the reinjection of thallium after stress-redistribution imaging. N Engl J Med 1990; 323: 141-6.
    CrossrefPubMedSearch in Google Scholar
  • 10 Dilsizian V, Manin-Ncto JA, Arrighi JA. et al. Myocardial viability: comparison of thallium reinjection, rcst-strcss sestamibi, and positron emission tomography. J Am Coll Cardiol 1992; 19: 21A.
    CrossrefPubMedSearch in Google Scholar
  • 11 Fabcr TL, Akcrs MS, Pcshock RM. et al. Three dimensional motion and perfusion quantification in gated single photon emission computed tomograms. J Nucl Med 1991; 32: 2311-7.
    PubMedSearch in Google Scholar
  • 12 Friedman J, Train KV, Kial H. et al. Simultaneous dual isotope rest/stress myocardial perfusion scintigraphy: a feasibility study. J Am Coll Cardiol 1991; 17: 390A.
    Search in Google Scholar
  • 13 Jones RH, Borges-Ncto S, Potts HM. Simultaneous measurement of myocardial perfusion and ventricular function during exercise from a single injection of technc-tium-99m sestamibi in coronary disease. Am J Cardiol 1990; 66: 68E.
    CrossrefPubMedSearch in Google Scholar
  • 14 Kial H, Friedman J, Train KV. et al. Simultaneous rest TI-201 /stress Tc-99m sestamibi dual isotope myocardial perfusion SPECT: a pilot study. J Nucl Med 1991; 32: 1006.
    Search in Google Scholar
  • 15 Machac J. Technetium-99m isonitrile: a perfusion or a viability agent?. J Am Coll Cardiol 1989; 14: 1685-8.
    CrossrefPubMedSearch in Google Scholar
  • 16 Madahi J, Kial H, Berman DS. Myocardial perfusion imaging with tcchnctium-99m-la-bcled agents. Am J Cardiol 1991; 67: 27D-34D.
    CrossrefPubMedSearch in Google Scholar
  • 17 Mannting F, Morgan-Mannting MG. Gated SPECT with technetium-99m sestamibi for assessment of myocardial perfusion abnormalities. J Nucl Med 1993; 34: 601-8.
    PubMedSearch in Google Scholar
  • 18 Najm YC. et al. The evaluation of ventricular function using gated myocardial imaging with Tc-99m-MIBI. Eur Heart J 1989; 10: 142.
    PubMedSearch in Google Scholar
  • 19 Rahimtoola SH. The hibernating myocardium. Am Heart J 1989; 117: 211-3.
    CrossrefPubMedSearch in Google Scholar
  • 20 Rocco TP, Dilsizian V, McKusick KA. et al. Comparison of thallium redistribution with rest “reinjection” imaging for the detection of viable myocardium. Am J Cardiol 1990; 66: 158-63.
    CrossrefPubMedSearch in Google Scholar
  • 21 Schelbcrt HR. Myocardial ischemia and clinical applications of positron emission tomography. Am J Cardiol 1989; 64: 46E-53E.
    CrossrefPubMedSearch in Google Scholar
  • 22 Stirner H, Bucll U, Kleinhans E. et al. Myocardial kinetics of 99mTc hexakis-(2-methoxy-isobutyl-isonitrile) (HMIBI) in patients with coronary heart disease: a comparative study versus 201T1 with SPECT. Nucl Med Commun 1988; 9: 15-23.
    CrossrefPubMedSearch in Google Scholar
  • 23 Taillcfcr R. Technetium-99m sestamibi myocardial imaging: same-day rest-stress studies and dipyridamole. Am J Cardiol 1990; 66: 80E-84E.
    CrossrefPubMedSearch in Google Scholar
  • 24 Tilisch JH, Brunken R, Marshall R. et al. Reversibility of cardiac wall motion abnormalities predicted by positron emission tomography. N Engl J Med 1986; 314: 884-8.
    CrossrefPubMedSearch in Google Scholar
  • 25 Watson D, Schmith WH, Glover DK. et al. Dual isotope SPECT imaging of Tc-99m sestamibi and TI-201 comparing myocardial defect magnitudes. Circulation 1991; 84 II 11/314.
    Search in Google Scholar
  • 26 Whalley DR. Comments to: Clinical comparison between thallium-201 and Tc-99m-methoxy-isobuthyl-isonitrile (hexamibi) myocardial perfusion imaging for detection of coronary artery disease. Eur J Nucl Med 1989; 15: 805.
    PubMedSearch in Google Scholar
  • 27 Wcinstein H, McShcrry BA, King M. et al. Simultaneous stress/rest myocardial imaging with sestamibi and thallium-201 using patient specific spill correction. Circulation 1991; 84 SupplII 11/314
    Search in Google Scholar