Assessing coronary artery disease with dipyridamole technetium-99m-tetrofosmin SPECT: a multicenter trial

Abstract

Exercise 99mTc-tetrofosmin myocardial scintigraphy is as accurate as exercise 201TI imaging. Thus far, no data are available on tetrofosmin imaging during pharmacologic stress. We evaluated the feasibility of using. 99mTc-tetrofosmin myocardial SPECT during vasodilation with dipyridamole for detecting coronary artery disease.

Methods: Sixty-four patients, enrolled in three centers in the U.S., underwent one-day dipyridamole/rest tetrofosmin SPECT. Coronary angiography, performed in 59 patients within 2 mo of the SPECT study, revealed normal coronary arteries or insignificant coronary stenosis in 11 patients and significant (> or = 50% luminal diameter stenosis) coronary stenoses in 48 patients.

Results: Sensitivity and specificity of tetrofosmin SPECT for detecting coronary artery disease were 85% and 55%, respectively, in the overall population and 81% and 55% in patients without prior coronary artery bypass surgery. The overall sensitivity and specificity of tetrofosmin tomographic imaging for detection of individual coronary stenoses were 53% and 72%, respectively, in the overall population and 54% and 80% in the patients without prior coronary artery bypass surgery.

Conclusion: One-day dipyridamole/rest 99mTc-tetrofosmin myocardial perfusion imaging is feasible and has a high sensitivity for detection of coronary artery disease.