Quantitative exercise technetium-99m tetrofosmin myocardial tomography for the identification and localization of coronary artery disease

Pasquale Sullo, Alberto Cuocolo, Emanuele Nicolai, Stefania Cardei, Antonio Nappi, Fiorenzo Squame, Eugenio M. Covelli, Leonardo Pace, Marco Salvatore

Research output: Contribution to journalArticlepeer-review

Abstract

The aim of this study was to evaluate the accuracy of quantitative 1-day exercise-rest technetium-99m tetrofosmin tomography in the identification of patients with coronary artery disease (CAD) and in the detection of individual stenosed coronary vessels. Sixty-one patients with suspected CAD who underwent coronary angiography and 13 normal volunteers were studied. All patients were submitted to two i.v. injections of 99mTc-tetrofosmin, one at peak exercise (370 MBq) and the other (1110 MBq) at rest 3 h after exercise (images 15-30 min after injection for both studies). All patients with CAD (≥ 50% luminal stenosis) (n = 50) had an abnormal 99mTc-tetrofosmin tomogram. Only one patient without significant coronary narrowing showed abnormal findings. Overall sensitivity, specificity and diagnostic accuracy in the detection of individual stenosed vessels were 77%, 93% and 85%, respectively. Sensitivity and diagnostic accuracy in the identification of individuals stenosed coronary vessels were significantly higher (P <0.05) in patients with single-vessel disease (n = 21) than in those with multivessel disease (n = 29). Sensitivity, specificity and accuracy for detecting individual diseased vessels were similar in patients without previous myocardial infarction (n = 26) and in those with previous myocardial infarction (n = 35). In myocardial territories related to non-infarcted areas (n = 128), sensitivity and specificity in the detection of stenosed vessels were 70% and 95%, respectively. In infarcted areas (n = 55), sensitivity and specificity in the detection of stenosed vessels were 85% (P = NS vs non-infarcted areas) and 75% (P <0.05 vs non-infarcted areas), respectively. Finally, sensitivity was significantly lower (P <0.05) in vascular territories supplied by vessels with moderate stenosis (50%-75%) than in those supplied by vessels with severe stenosis (> 75%). The results of this study demonstrate that quantitative 1-day exercise-rest 99mTc-tetrofosmin single-photon emission tomographic imaging is a suitable and accurate technique to identify patients with CAD and to detect individual stenosed coronary vessels.

Original languageEnglish
Pages (from-to)648-655
Number of pages8
JournalEuropean Journal Of Nuclear Medicine
Volume23
Issue number6
DOIs
Publication statusPublished - 1996

Keywords

  • Myocardial perfusion
  • Single-photon emission tomography
  • Technetium-99m-labelled agents

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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