Clinical Feasibility of Simultaneous Acquisition Rest (99m)Tc/Stress (201)Tl Dual-Isotope Myocardial Perfusion Single-Photon Emission Computed Tomography With Semiconductor Camera

Abstract

Background: The aim of this study was to evaluate the clinical feasibility of simultaneous acquisition of rest (99m)Tc-tetrofosmin/stress (201)Tl dual-isotope single-photon emission computed tomography with a semiconductor gamma camera.

Methods and results: Ninety-four patients with known or suspected coronary artery disease (CAD) were enrolled in the study. First, patients were injected with (99m)Tc-tetrofosmin (296 MBq) for rest imaging, followed by (201)Tl (74 MBq) injection during 6 min of vasodilator stress test. Immediately after the stress test, the patients underwent the first electrocardiogram (ECG)-gated simultaneous acquisition including rest and stress perfusion scans. Patients were brought back for the second simultaneous acquisition for the comparison of ECG-gated wall motion between stress and rest scan 30 min later. Coronary angiography was performed in all the patients within 3 months of this protocol. Sensitivity, specificity and accuracy on a per patient basis to detect significant coronary artery stenosis (≥75%) were 88.6%, 79.2% and 86.2%, respectively. Per coronary vessel, sensitivity, specificity and accuracy were as follows: 84.9%, 80.5% and 83% in the left anterior descending coronary artery; 75%, 93.1% and 86.2% in the left circumflex coronary artery; and 74.2%, 85.7% and 81.9% in the right coronary artery.

Conclusions: Simultaneous acquisition of rest (99m)Tc-tetrofosmin/stress (201)Tl dual-isotope protocol had high diagnostic accuracy for significant CAD. (Circ J 2016; 80: 689-695).