Comparison of electrocardiographic-gated technetium-99m sestamibi single-photon emission computed tomographic imaging and rest-redistribution thallium-201 in the prediction of myocardial viability

Duncan, Brett; Ahlberg, Alan W.; Levine, Michael G.; McGill, Carol C.; Mann, April; White, Michael P.; Mather, Jeffrey; Waters, David D.; Heller, Gary V.

doi:10.1016/s0002-9149(99)00840-1

Cited by 22 publications

(9 citation statements)

References 16 publications

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“…54 In studies that evaluated the improvement of function on a segmental basis (Table 2), SPECT and PET demonstrate excellent sensitivity, whereas echocardiography and cardiovascular magnetic resonance with dobutamine stress have superior specificity and positive predictive value. 22,66,67,70,[72][73][74][75][76][77][78][79][80][81] In a preliminary study in a small group of patients, late-enhancement cardiovascular magnetic resonance in direct comparison with 99m Tc-sestamibi and FDG-PET showed better negative predictive value for segments classified as nonviable 6 months after revascularization. 67 In interpreting these results, we must consider several potential confounding factors.…”

Section: Camici Et Al Stunning Hibernation and Assessment Of Viabilitymentioning

confidence: 90%

Stunning, Hibernation, and Assessment of Myocardial Viability

2008

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Section: Camici Et Al Stunning Hibernation and Assessment Of Viabilitymentioning

confidence: 90%

Stunning, Hibernation, and Assessment of Myocardial Viability

2008

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“…As in many other studies using functional recovery as the reference standard to define myocardial viability, the patient population is quite small. 9,11,12 A limitation of gated SPECT compared with echocardiography is the impossibility to monitor changes during dobutamine infusion, and so to differentiate between lack of improvement and biphasic response, which is considered the most reliable marker of preserved viability in dobutamine echocardiography. 26,27 Conversely, we did not perform a quantitative analysis of wall motion and thickening on gated SPECT images.…”

Section: Discussionmentioning

confidence: 99%

Prediction of functional recovery in patients with chronic coronary artery disease and left ventricular dysfunction combining the evaluation of myocardial perfusion and of contractile reserve using nitrate-enhanced technetium-99m sestamibi gated single-photon emission computed tomography and Dobutamine stress

Leoncini

Marcucci

Sciagrà

et al. 2001

The American Journal of Cardiology

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This study aimed to assess whether contractile reserve evaluation using dobutamine gated single-photon emission computed tomography (SPECT) improves the capability of quantitative perfusion analysis to predict functional recovery of viable hibernating myocardium. Resting and dobutamine nitrate-enhanced technetium99m sestamibi (sestamibi) gated SPECT studies were performed in patients with coronary artery disease who had left ventricular dysfunction. Tracer activity was quantified, and wall motion and thickening visually scored. Reversible dysfunction was identified with gated SPECT repeated after coronary revascularization. Using the best activity threshold, perfusion quantification achieved 85% sensitivity and 55% specificity. Contractile reserve detection was significantly less sensitive (64%, p <0.0005), but more specific (88%, p <0.00001) than perfusion quantification. However, in the subgroup of hypokinetic segments, the sensitivity of contractile reserve assessment was just slightly lower than perfusion quantification (72% vs 91%, p ‫؍‬ NS), whereas specificity was significantly higher (94% vs 23%, p <0.00001). Conversely, in the adyskinetic segments, perfusion quantification was significantly more sensitive than contractile reserve (82% vs 59%, p <0.005), but similarly specific (76% vs 85%, p ‫؍‬ NS). Therefore, the identification of reversible dysfunction based on perfusion quantification in adyskinetic segments and on contractile reserve detection in hypokinetic segments was significantly more specific (83% vs 55%, p <0.00001) than standard quantitative perfusion SPECT, without major loss in sensitivity (78% vs 85%, p ‫؍‬ NS). In conclusion, contractile reserve evaluation using dobutamine gated SPECT enhances the reliability of nitrate-enhanced sestamibi SPECT when used to predict reversible dysfunction in hypokinetic segments, whereas perfusion quantification remains superior in adyskinetic segments.

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“…To further improve viability assessment with the 99m Tclabeled agents, two modifications of the protocol have been proposed: gated imaging and administration of nitrates prior to imaging. Two studies demonstrated the improvement in accuracy for the assessment of viability when gated imaging was used [28,29].…”

Section: M Tc -Labeled Tracers To Assess Perfusion and Intactness Omentioning

confidence: 99%

Assessment of myocardial viability by nuclear imaging techniques

Bax

Poldermans²,

Elhendy³

et al. 2005

Curr Cardiol Rep

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The assessment of myocardial viability has become important in the diagnostic and prognostic work up of patients with ischemic cardiomyopathy. Patients with viable myocardium may benefit from revascularization in terms of improvement of function, symptoms, and prognosis. In contrast, patients without viable myocardium do not benefit and should be treated conservatively. Various nuclear imaging techniques are available.

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Comparison of electrocardiographic-gated technetium-99m sestamibi single-photon emission computed tomographic imaging and rest-redistribution thallium-201 in the prediction of myocardial viability

Cited by 22 publications

References 16 publications

Stunning, Hibernation, and Assessment of Myocardial Viability

Stunning, Hibernation, and Assessment of Myocardial Viability

Assessment of myocardial viability by nuclear imaging techniques

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