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Resting technetium-99m methoxyisobutylisonitrile cardiac imaging in chronic coronary artery disease: comparison with rest-redistribution thallium-201 scintigraphy

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Abstract

We studied 19 patients with angiographically proven coronary artery disease and left ventricular dysfunction (ejection fraction 33% ± 8%) by resting technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) and rest-redistribution thallium-201 cardiac imaging. Thallium and (99mTc-MIBI) studies were visually analysed. Of 285 segments, 203 (71%) had normal thallium uptake, 48 (17%) showed reversible thallium defects and 34 (12%) showed irreversible thallium defects. Of these 34 irreversible thallium defects, 19 (56%) were moderate and 15 (44%) were severe. Of the corresponding 285 segments, 200 (70%) had normal 99mTc-MIBI uptake, while 37 (13%) showed moderate and 48 (17%) showed severe reduction of 99 99mTc-MIBI uptake. Myocardial segmental agreement for regional uptake score between initial thallium and resting (99mTc-MIBI) images was 90% (κ=0.78). Segmental agreement between delayed thallium and resting 99Tc-MIBI images was 77% (κ=0.44). In particular, in 26 (9%) segments 99mTc-MIBI uptake was severely reduced while delayed thallium uptake was normal or only moderately reduced. These data suggest that although rest-redistribution thallium and resting (99mTc-MIBI) cardiac imaging provide concordant results in the majority of myocardial segments, some segments with severely reduced resting 99mTc-MIBI uptake may contain viable but hypoperfused myocardium. Thus, conclusions on myocardial viability based on 99mTc-MIBI uptake should be made with caution in chronic coronary artery disease.

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Authors and Affiliations

  1. Department of Nuclear Medicine, University Federico II, Napoli, Italy

    Alberto Cuocolo, Simone Maurea, Leonardo Pace, Emanuele Nicolai, Antonio Nappi & Massimo Imbriaco

  2. Department of Internal Medicine, University Federico II, Napoli, Italy

    Bruno Trimarco

  3. National Cancer Institute, Napoli, Italy

    Marco Salvatore

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  1. Alberto Cuocolo
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  2. Simone Maurea
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  3. Leonardo Pace
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  4. Emanuele Nicolai
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  7. Bruno Trimarco
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  8. Marco Salvatore
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Cuocolo, A., Maurea, S., Pace, L. et al. Resting technetium-99m methoxyisobutylisonitrile cardiac imaging in chronic coronary artery disease: comparison with rest-redistribution thallium-201 scintigraphy. Eur J Nucl Med 20, 1186–1192 (1993). https://doi.org/10.1007/BF00171017

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  • DOI: https://doi.org/10.1007/BF00171017

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