Enhanced thallium-201 uptake after reinjection: Relation to regional ventricular function, myocardial perfusion and coronary anatomy

A. Cuocolo, L. Pace, S. Maurea, B. Ricciardelli, E. Nicolai, A. Nappi, M. Imbriaco, B. Trimarco, M. Salvatore

Research output: Contribution to journalArticle

Abstract

The aim of this study was to clarify the significance of enhanced thallium-201 (201Tl) uptake after reinjection following 4-hour redistribution imaging. Thirty-four patients with coronary artery disease (CAD) and left ventricular (LV) dysfunction (ejection fraction 32 ± 10%) underwent exercise-redistribution (ER) 201Tl scintigraphy with rest reinjection, resting technetium-99m methoxy isobutyl isonitrile (MIBI) imaging, 2D-echocardiography, and coronary angiography. Wall motion (WM) was graded on echocardiographic images. A total of 510 myocardial segments were quantitatively analyzed. A total of 267 (52%) segments had normal (N) 201Tl uptake, 53 (10%) reversible (RD), and 190 (37%) irreversible (ID) 201Tl defects on ER images. Of these 190 ID, 84 (44%) showed enhanced 201Tl uptake after reinjection (Re+) and 106 (56%) remained unchanged after reinjection (Re-). MIBI uptake was significantly higher in RD compared to Re+ and Re- (both p <0.01), and in Re+ compared to Re- (p <0.01). The WM score was significantly lower in RD and Re+ compared to Re- (p <0.01), while no difference was observed between RD and Re+. The severity of coronary artery stenosis was significantly lower in RD compared to Re+ and Re- (both p <0.01), but no difference was observed between Re+ and Re-. The occurrence of collaterals was significantly higher (p <0.01) in Re+ (69%) compared to Re- (38%). In conclusion, in patients with CAD and impaired LV function, enhanced 201Tl uptake after reinjection in myocardial segments with ID on ER images was associated with less severe WM abnormalities, higher MIBI uptake and the presence of collaterals. Thus, 201Tl reinjection should be performed when ID are observed on redistribution images to identify severely ischemic but still viable myocardium.

Original languageEnglish
Pages (from-to)6-13
Number of pages8
JournalJournal of nuclear biology and medicine (Turin, Italy : 1991)
Volume38
Issue number1
Publication statusPublished - 1994

Keywords

  • coronary anatomy
  • myocardial perfusion
  • thallium-201
  • ventricular function

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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