Quantitative rest technetium-99m tetrofosmin imaging in predicting functional recovery after revascularization: comparison with rest-redistribution thallium-201

Department of Nuclear Medicine, Kanazawa University School of Medicine, Japan.

OBJECTIVES: This study was undertaken to 1) compare the regional myocardial tracer distributions between rest technetium (Tc)-99m tetrofosmin and rest-redistribution thallium (Tl)-201 images in patients with coronary artery disease and left ventricular dysfunction; and 2) assess the comparative values of these agents for predicting functional recovery after revascularization. BACKGROUND: Tc-99m tetrofosmin is a new myocardial perfusion imaging agent, but its role for detecting viable myocardium is still unclear. METHODS: Thirty-six patients with coronary artery disease and left ventricular dysfunction underwent rest Tc-99m tetrofosmin, rest-redistribution Tl-201 and gated blood pool scintigraphy. In 21 patients with successful revascularization confirmed by follow-up angiography, gated blood pool scintigraphy was repeated after revascularization. Optimal threshold cutoffs to separate reversible from irreversible dysfunction were determined by receive operating characteristic analysis. RESULTS: Regional Tc-99m tetrofosimin activity highly correlated with redistribution Tl-201 activity (r = 0.93). The diagnostic performance for predicting functional recovery, as measured by the area under the receiver operating characteristic curves, measured 0.66 +/- 0.07 (mean +/- SD) for Tc-99m tetrofosmin and 0.67 +/- 0.07 for Tl-201 (p = 0.60, 96.7% power to detect difference in area of 0.10). The optimal threshold cutoffs for viability were considered to be 50% of peak activity for Tc-99m tetrofosmin and 55% of peak activity for Tl-201. The positive and negative predictive values for reversible dysfunction were, respectively, 69% and 82% for Tc-99m tetrofosmin and 69% (p = 0.99 vs. Tc-99m tetrofosmin) and 71% (p = 0.66 vs. Tc-99m tetrofosmin) by Tl-201. CONCLUSIONS: The diagnostic performance of quantitative rest Tc-99m tetrofosmin imaging in predicting functional recovery after revascularization is comparable to that of rest-redistribution Tl-201.

This article has been cited by other articles:

				H. Yaoita, S. Takase, Y. Maruyama, Y. Sato, H. Satokawa, N. Hoshi, N. Ono, T. Igari, H. Ohto, and H. Yokoyama Scintigraphic Assessment of the Effects of Bone Marrow-Derived Mononuclear Cell Transplantation Combined with Off-Pump Coronary Artery Bypass Surgery in Patients with Ischemic Heart Disease J. Nucl. Med., October 1, 2005; 46(10): 1610 - 1617. [Abstract] [Full Text] [PDF]

				K. Yoshinaga, C. Katoh, R. S.B. Beanlands, K. Noriyasu, K. Komuro, S. Yamada, Y. Kuge, K. Morita, A. Kitabatake, and N. Tamaki Reduced Oxidative Metabolic Response in Dysfunctional Myocardium with Preserved Glucose Metabolism but with Impaired Contractile Reserve J. Nucl. Med., November 1, 2004; 45(11): 1885 - 1891. [Abstract] [Full Text] [PDF]

				H. P. Kuhl, A. M. Beek, A. P. van der Weerdt, M. B. M. Hofman, C. A. Visser, A. A. Lammertsma, N. Heussen, F. C. Visser, and A. C. van Rossum Myocardial viability inchronic ischemic heart disease: Comparison of contrast-enhanced magnetic resonance imaging with 18F-fluorodeoxyglucose positron emission tomography J. Am. Coll. Cardiol., April 16, 2003; 41(8): 1341 - 1348. [Abstract] [Full Text] [PDF]

				I. Matsunari, J. Taki, and N. Tonami Sequential Strategy Using Multimodality Viability Tests: Does It Work? J. Nucl. Med., June 1, 2002; 43(6): 803 - 805. [Full Text] [PDF]

				C Anagnostopoulos, M Y Henein, and S R Underwood Non-invasive investigations: Ischaemic heart disease Br. Med. Bull., October 1, 2001; 59(1): 29 - 44. [Abstract] [Full Text] [PDF]

				C Anagnostopoulos and S R Underwood Cardiac imaging Imaging, September 1, 2001; 13(3): 155 - 163. [Abstract] [Full Text] [PDF]

				K. Yoshinaga, K. Morita, S. Yamada, K. Komuro, C. Katoh, Y. Ito, Y. Kuge, T. Kohya, A. Kitabatake, and N. Tamaki Low-Dose Dobutamine Electrocardiograph-Gated Myocardial SPECT for Identifying Viable Myocardium: Comparison with Dobutamine Stress Echocardiography and PET J. Nucl. Med., June 1, 2001; 42(6): 838 - 844. [Abstract] [Full Text] [PDF]

				I. Matsunari, G. Boning, S. I. Ziegler, S. G. Nekolla, J. C. Stollfuss, I. Kosa, E. P. Ficaro, and M. Schwaiger Attenuation-corrected 99mTc-tetrofosmin single-photon emission computed tomography in the detection of viable myocardium: comparison with positron emission tomography using 18F-fluorodeoxyglucose J. Am. Coll. Cardiol., October 1, 1998; 32(4): 927 - 935. [Abstract] [Full Text] [PDF]