Availability and Limitations of Thallium-201 Myocardial SPECT Quantitative Analysis: Assessment As Daily Routine Procedure for Ischemic Heart Disease

Overview

Journal Ann Nucl Med

Date 1991 Mar 1

PMID 1863518

Authors

Y Takao

H Murata

K Katoh

Affiliations

Soon will be listed here.

Abstract

To determine the availability and limitations of the detection of ischemic lesions by stress thallium-201 myocardial SPECT as the daily routine procedure, we compared and evaluated the detectability of the quantitative analysis (%uptake and washout rate (WR)) and visual evaluation in 104 patients with effort angina and 17 normal subjects. Visual evaluation combined with WR analysis resulted in significantly higher sensitivity (88.0%) but lower specificity (60.2%) than the other methods. The sensitivity by visual evaluation was quite low in multivessel disease (MVD), and in the regions supplied by mild coronary stenosis or by the left circumflex artery. These were markedly improved by combining visual evaluation and WR analysis, but sensitivity in the MVD group was unsatisfactory even with this analytic method in comparison with the single vessel disease group. One of the causes of low sensitivity in the MVD group might be the "true negative": No induction of the ischemia in the regions of milder stenosis, or the regions supplied by the collateral coronary flow. We therefore conclude that the combination of visual evaluation as a qualitative analysis and WR analysis as a quantitative analysis, is the most useful daily routine procedure as a screening test for detecting ischemia.

References

Pohost G, Zir L, Moore R, McKusick K, Guiney T, Beller G . Differentiation of transiently ischemic from infarcted myocardium by serial imaging after a single dose of thallium-201. Circulation. 1977; 55(2):294-302. DOI: 10.1161/01.cir.55.2.294. View

Narita M, Kurihara T, Murano K, Usami M, Honda M, Tomonobu M . [Factors affecting myocardial thallium-201 washout rate after exercise stress and their significance for the detection of coronary artery disease]. Kaku Igaku. 1988; 25(2):141-50. View

Burow R, Pond M, Schafer A, Becker L . "Circumferential profiles:" a new method for computer analysis of thallium-201 myocardial perfusion images. J Nucl Med. 1979; 20(7):771-7. View

GEWIRTZ H, Paladino W, Sullivan M, Most A . Value and limitations of myocardial thallium washout rate in the noninvasive diagnosis of patients with triple-vessel coronary artery disease. Am Heart J. 1983; 106(4 Pt 1):681-6. DOI: 10.1016/0002-8703(83)90087-x. View

Tamaki N, Yonekura Y, Mukai T, Kodama S, Kadota K, Kambara H . Stress thallium-201 transaxial emission computed tomography: quantitative versus qualitative analysis for evaluation of coronary artery disease. J Am Coll Cardiol. 1984; 4(6):1213-21. DOI: 10.1016/s0735-1097(84)80140-0. View

Camici P, Araujo L, Spinks T, Lammertsma A, Kaski J, Shea M . Increased uptake of 18F-fluorodeoxyglucose in postischemic myocardium of patients with exercise-induced angina. Circulation. 1986; 74(1):81-8. DOI: 10.1161/01.cir.74.1.81. View

Kaul S, Chesler D, Pohost G, Strauss H, Okada R, Boucher C . Influence of peak exercise heart rate on normal thallium-201 myocardial clearance. J Nucl Med. 1986; 27(1):26-30. View

Klein J, Garcia E, DePuey E, Campbell J, TAYLOR A, Pettigrew R . Reversibility bull's-eye: a new polar bull's-eye map to quantify reversibility of stress-induced SPECT thallium-201 myocardial perfusion defects. J Nucl Med. 1990; 31(7):1240-6. View

Okuzumi I . [Assessment of relative washout rate (rW-R) in stress T1-201 myocardial SPECT]. Kaku Igaku. 1989; 26(3):329-38. View

10.

Narita M, Kurihara T, Murano K, Usami M, Honda M, Tomonobu M . [Quantitative analysis of exercise stress thallium-201 myocardial tomography: the evaluation of bull's-eye map representation for the detection of coronary artery disease]. Kaku Igaku. 1987; 24(1):55-64. View

11.

Maddahi J, Garcia E, Berman D, Waxman A, Swan H, Forrester J . Improved noninvasive assessment of coronary artery disease by quantitative analysis of regional stress myocardial distribution and washout of thallium-201. Circulation. 1981; 64(5):924-35. DOI: 10.1161/01.cir.64.5.924. View

12.

Matsuda H, Murata H, Toyama H, Nishimura S, Katoh K . [Development of a new quantitative analysis for thallium myocardial SPECT images--quantitative STEREO-VIEW method and evaluation of its clinical usefulness]. Kaku Igaku. 1989; 26(7):845-54. View

13.

Rigo P, Becker L, Griffith L, Alderson P, Bailey I, Pitt B . Influence of coronary collateral vessels on the results of thallium-201 myocardial stress imaging. Am J Cardiol. 1979; 44(3):452-8. DOI: 10.1016/0002-9149(79)90396-5. View

14.

Rigo P, Bailey I, Griffith L, Pitt B, Wagner Jr H, Becker L . Stress thallium-201 myocardial scintigraphy for the detection of individual coronary arterial lesions in patients with and without previous myocardial infarction. Am J Cardiol. 1981; 48(2):209-16. DOI: 10.1016/0002-9149(81)90598-1. View

15.

Maeda H, Lee J, Misawa T, Ishii Y, Nakamura T, Miyabo S . [Bull's eye- analyses in polar coordinate]. Kaku Igaku. 1988; 25(8):759-65. View

16.

Garcia E, Van Train K, Maddahi J, Prigent F, Friedman J, Areeda J . Quantification of rotational thallium-201 myocardial tomography. J Nucl Med. 1985; 26(1):17-26. View

17.

Kojima Y, Murata H, Nishimura S . [Comparative evaluation of some analyses of stress-redistribution thallium-201 myocardial SPECT for myocardial ischemia]. Kaku Igaku. 1987; 24(10):1511-20. View

18.

Nakajima K, Muramori A, Taki J, Bunko H, Taniguchi M, Nanbu I . [Evaluation of ischemic heart disease by thallium-201 washout-rate map using SPECT]. Kaku Igaku. 1989; 26(5):617-23. View