Technetium-99m tetrofosmin rest/stress myocardial SPET with a same-day 2-hour protocol: comparison with coronary angiography A Spanish-Portuguese multicentre clinical trial

Abstract

Technetium-99m tetrofosmin (Myoview) has unique properties for myocardial perfusion imaging very early after injection of the tracer. We used a very short same-day rest/stress protocol, to be performed within 2 h and evaluated its diagnostic accuracy. The study included 144 patients from seven Spanish and four Portuguese centres with a diagnosis of uncomplicated coronary artery disease (CAD); 78 patients (54%) had no history of prior myocardial infarction. Patients were injected with </=300 MBq 99mTc-tetrofosmin at rest and </=900 MBq approximately 1 h later at peak exercise. Single-photon emission tomographic (SPET) acquisitions were initiated within 5-30 min post injection. The results were compared with those of coronary angiography (CA). The data of 142 patients were completely evaluable (two with non-evaluable images were excluded). The quality of rest images was excellent or good in 86%, regionally problematic in 7%, poor but well interpretable in 5% and non-evaluable in 2%. The overall sensitivity for the detection of CAD was 93%, the specificity 38% and the accuracy 85%. The localization of defects by SPET in relation to the perfusion territories of stenosed vessels (>/=50%) was achieved with a sensitivity of 64% for the left anterior descending artery, 49% for the left circumflex artery and 86% for the right coronary artery, and an accuracy of 71%, 72% and 73% respectively. Concordance of SPET and CA was 62% for single-vessel disease and 68% for multivessel disease. In conclusion, this Spanish-Portuguese multicentre clinical trial confirmed, in a considerable number of patients who underwent coronary angiography, the feasibility of 99mTc tetrofosmin (Myoview) rest/stress myocardial SPET using a very short protocol (2 h).

Comparison of 1‐ and 2‐day protocols for myocardial SPECT: a Monte Carlo study

“…This means that there is a trade-off between the image quality in terms of a high signal-to-noise ratio in the first study and the unwanted contribution from the residual activity from this study in the second study. Clinical studies support the usefulness of both 1-and 2-day protocols (Berman et al, 1994;Bratt et al, 1994;Van Train et al, 1994;Montz et al, 1996), but a detailed comparison of these protocols has, to our knowledge, not been performed previously.…”

“…, 1994; Van Train et al. , 1994; Montz et al. , 1996), but a detailed comparison of these protocols has, to our knowledge, not been performed previously.…”

“…Myocardial perfusion scintigraphy with single-photon emission computed tomography (SPECT) is a method that is widely used to assess ischaemic heart diseases (Underwood et al, 2004). Such investigations are carried out by combining a rest study and a stress study that are performed either on the same day or on two separate days (Berman et al, 1994;Bratt et al, 1994;Montz et al, 1996;DePuey & Garcia, 2001). A 1-day protocol can be performed either as a stress-rest or a rest-stress combination.…”

Diagnostic Value of 123I-Betamethyl-p-Iodophenyl-Pentadecanoic Acid (BMIPP) Single Photon Emission Computed Tomography (SPECT) in Patients With Chest Pain-Comparison With Rest-Stress 99mTc-Tetrofosmin SPECT and Coronary Angiography-

“…27 Clinical studies have shown that tetrofosmin SPECT gives an extremely accurate diagnosis of CAD. [28][29][30][31][32] A BMIPP SPECT study cannot be performed at the time of admission and the following day is the earliest. Accordingly, the appearance of abnormal BMIPP findings may be quite limited.…”

Miyokard perfüzyon sintigrafisi Myocardial perfusion scintigraphy

“…MIBI çalışmasında olduğu gibi, stres ve istirahat esnasında olmak üzere iki ayrı enjeksiyon yapılması gerekir. MIBI'ye göre daha erken görüntüleme avantajına sahiptir (4,8).…”