Identification of viable myocardium in patients with chronic coronary artery disease: Comparison of thallium-201 scintigraphy with reinjection and technetium-99m-methoxyisobutyl isonitrile

A. Cuocolo, L. Pace, B. Ricciardelli, M. Chiariello, B. Trimarco, M. Salvatore

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Abstract

We compared the results of 201Tl reinjection and those of 99mTc- methoxyisobutyl isonitrile (MIBI) in identifying viable myocardium in 20 male patients with angiographically proven coronary artery disease (CAD) and left ventricular dysfunction (ejection fraction 30%±8%). All patients had irreversible defects on standard exercise-redistribution thallium imaging. Thallium was reinjected immediately after the redistribution study, and images were reacquired. The patients also underwent stress and rest 99mTc- MIBI myocardial scintigraphy (2-day protocol). A total of 300 myocardial regions were analyzed, of which 122 (41%) had irreversible thallium defects on redistribution images before reinjection. Of the 122 myocardial regions with irreversible defects on standard stress-redistribution thallium cardiac imaging, 65 (53%) did not change at reinjection and 57 (47%) demonstrated enhanced uptake of thallium after reinjection. Of the same 122 irreversible defects on stress-redistribution thallium, 100 (82%) appeared as fixed defects and 22 (18%) were reversible on 99mTc-MIBI myocardial scintigraphy. These data indicate that 201Tl cardiac imaging with rest reinjection is superior to 99mTc-MIBI myocardial scintigraphy in identifying viable myocardium in patients with chronic CAD, suggesting that regions with severe reduction of 99mTc-MIBI uptake both on stress and rest images may contain viable myocardium.

Original languageEnglish
Pages (from-to)505-511
Number of pages7
JournalJournal of Nuclear Medicine
Volume33
Issue number4
Publication statusPublished - 1992

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Thallium
Technetium
Radionuclide Imaging
Coronary Artery Disease
Myocardium
Myocardial Perfusion Imaging
Left Ventricular Dysfunction
Stroke Volume
Exercise

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

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Identification of viable myocardium in patients with chronic coronary artery disease : Comparison of thallium-201 scintigraphy with reinjection and technetium-99m-methoxyisobutyl isonitrile. / Cuocolo, A.; Pace, L.; Ricciardelli, B.; Chiariello, M.; Trimarco, B.; Salvatore, M.

In: Journal of Nuclear Medicine, Vol. 33, No. 4, 1992, p. 505-511.

Research output: Contribution to journalArticle

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abstract = "We compared the results of 201Tl reinjection and those of 99mTc- methoxyisobutyl isonitrile (MIBI) in identifying viable myocardium in 20 male patients with angiographically proven coronary artery disease (CAD) and left ventricular dysfunction (ejection fraction 30{\%}±8{\%}). All patients had irreversible defects on standard exercise-redistribution thallium imaging. Thallium was reinjected immediately after the redistribution study, and images were reacquired. The patients also underwent stress and rest 99mTc- MIBI myocardial scintigraphy (2-day protocol). A total of 300 myocardial regions were analyzed, of which 122 (41{\%}) had irreversible thallium defects on redistribution images before reinjection. Of the 122 myocardial regions with irreversible defects on standard stress-redistribution thallium cardiac imaging, 65 (53{\%}) did not change at reinjection and 57 (47{\%}) demonstrated enhanced uptake of thallium after reinjection. Of the same 122 irreversible defects on stress-redistribution thallium, 100 (82{\%}) appeared as fixed defects and 22 (18{\%}) were reversible on 99mTc-MIBI myocardial scintigraphy. These data indicate that 201Tl cardiac imaging with rest reinjection is superior to 99mTc-MIBI myocardial scintigraphy in identifying viable myocardium in patients with chronic CAD, suggesting that regions with severe reduction of 99mTc-MIBI uptake both on stress and rest images may contain viable myocardium.",
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