Clinical Comparison Between Thallium-201 and Tc-99m-methoxy Isobutyl Isonitrile (hexamibi) Myocardial Perfusion Imaging for Detection of Coronary Artery Disease

Overview

Journal Eur J Nucl Med

Specialty Nuclear Medicine

Date 1989 Jan 1

PMID 2527750

Citations 22

Authors

R Taillefer

R Lambert

G Dupras

J Gregoire

J Leveille

R Essiambre

D C Phaneuf

Affiliations

Soon will be listed here.

Abstract

99mTc-hexamibi (methoxy isobutyl isonitrile) is a new 99mTc-hexakis analog that can be used as a myocardial perfusion imaging agent. The purposes of this study were to compare 99mTc-hexamibi to 201Tl-thallous chloride myocardial stress scintigraphy in patients referred for investigation of chest pain and to evaluate the sensitivity of 99mTc-hexamibi in detection of coronary artery disease. One hundred patients were prospectively studied with both 201Tl and 99mTc-hexamibi planar imaging. Sixty five patients had a current coronary angiography. There was a total of 97 significantly (less than or equal to 70%) stenosed major coronary arteries. 99mTc-hexamibi (25 mCi) study was done within a week of the 201Tl scan with similar double products upon standard treadmil stress testing. Rest studies with 99mTc-hexamibi were obtained 24-48 h after the stress test using the same acquisition parameters and dose. Analysis was performed blind by three observers. The left ventricle was divided into five segments in each image. Analysis of 201Tl and 99mTc-hexamibi results in 1500 left ventricle segments showed an overall agreement in 1326/1500 (88.4%) segments. Correlation between the patient diagnosis on the 201Tl and 99mTc-hexamibi studies showed an agreement in 89 patients (89%). 201Tl revealed myocardial uptake defects in 526 segments, detecting 72 out of 97 (74.2%) significantly stenosed coronary arteries and 99mTc-hexamibi detected 513 segments corresponding to 68 (70.1%) stenosed arteries (no significant statistical difference). In conclusion, these results show a good correlation between 201Tl and 99mTc-hexamibi myocardial imaging in the detection of significant coronary artery disease.

Citing Articles

Myocardial perfusion imaging with 99mTc-labeled radiopharmaceuticals: How fast can a stress-rest same-day imaging protocol be completed?.

Taillefer R J Nucl Cardiol. 2016; 24(4):1328-1331.

PMID: 27044387 DOI: 10.1007/s12350-016-0461-z.

Should early post-stress imaging be performed on a routine clinical basis for myocardial perfusion studies?.

Taillefer R J Nucl Cardiol. 2014; 21(6):1177-80.

PMID: 25213202 DOI: 10.1007/s12350-014-9972-7.

Comparison of Tl-201 with Tc-99m-labeled myocardial perfusion agents: technical, physiologic, and clinical issues.

Kailasnath P, Sinusas A J Nucl Cardiol. 2001; 8(4):482-98.

PMID: 11481571 DOI: 10.1067/mnc.2001.115078.

No gender bias in referral for coronary angiography after myocardial perfusion scintigraphy with technetium-99m tetrofosmin.

Roeters van Lennep J, Borm J, Zwinderman A, Pauwels E, Bruschke A, van der Wall E J Nucl Cardiol. 1999; 6(6):596-604.

PMID: 10608586 DOI: 10.1016/s1071-3581(99)90096-x.

Comparison of exercise, dipyridamole, adenosine, and dobutamine stress with the use of Tc-99m tetrofosmin tomographic imaging.

LEVINE M, Ahlberg A, Mann A, White M, McGill C, MENDES de LEON C J Nucl Cardiol. 1999; 6(4):389-96.

PMID: 10461605 DOI: 10.1016/s1071-3581(99)90004-1.

References

Deutsch E, Glavan K, Sodd V, Nishiyama H, Ferguson D, Lukes S . Cationic Tc-99m complexes as potential myocardial imaging agents. J Nucl Med. 1981; 22(10):897-907. View

Sia S, HOLMAN B, McKusick K, Rigo P, Gillis F, Sporn V . The utilization of Tc-99m-TBI as a myocardial perfusion agent in exercise studies: comparison with Tl-201 thallous chloride and examination of its biodistribution in humans. Eur J Nucl Med. 1986; 12(7):333-6. DOI: 10.1007/BF00263814. View

Okada R, Boucher C, Strauss H, Pohost G . Exercise radionuclide imaging approaches to coronary artery disease. Am J Cardiol. 1980; 46(7):1188-204. DOI: 10.1016/0002-9149(80)90289-1. View

Taillefer R, Laflamme L, Dupras G, Picard M, Phaneuf D, Leveille J . Myocardial perfusion imaging with 99mTc-methoxy-isobutyl-isonitrile (MIBI): comparison of short and long time intervals between rest and stress injections. Preliminary results. Eur J Nucl Med. 1988; 13(10):515-22. DOI: 10.1007/BF00256627. View

Sia S, HOLMAN B, Campbell S, English R, Kronauge J, Davison A . The utilization of technetium-99m CPI as a myocardial perfusion imaging agent in exercise studies. Clin Nucl Med. 1987; 12(9):681-7. DOI: 10.1097/00003072-198709000-00001. View

HOLMAN B, Sporn V, Jones A, Sia S, Davison A, Kronauge J . Myocardial imaging with technetium-99m CPI: initial experience in the human. J Nucl Med. 1987; 28(1):13-8. View

Taillefer R, Dupras G, Sporn V, Rigo P, Leveille J, Boucher P . Myocardial perfusion imaging with a new radiotracer, technetium-99m-hexamibi (methoxy isobutyl isonitrile): comparison with thallium-201 imaging. Clin Nucl Med. 1989; 14(2):89-96. DOI: 10.1097/00003072-198902000-00004. View

Dudczak R, Angelberger P, Homan R, Kletter K, Schmoliner R, FRISCHAUF H . Evaluation of 99mTc-dichloro bis (1,2-dimethylphosphino) ethane (99mTc-DMPE) for myocardial scintigraphy in man. Eur J Nucl Med. 1983; 8(12):513-5. DOI: 10.1007/BF00251611. View

SANDS H, Delano M, Gallagher B . Uptake of hexakis(t-butylisonitrile) technetium (I) and hexakis(isopropylisonitrile) technetium (I) by neonatal rat myocytes and human erythrocytes. J Nucl Med. 1986; 27(3):404-8. View

10.

Jones A, Abrams M, Davison A, Brodack J, Toothaker A, Adelstein S . Biological studies of a new class of technetium complexes: the hexakis(alkylisonitrile)technetium(I) cations. Int J Nucl Med Biol. 1984; 11(3-4):225-34. DOI: 10.1016/0047-0740(84)90004-4. View

11.

Campbell S, HOLMAN B, Kirshenbaum J, Antman E, Davison A, Kozlowski J . The scintigraphic evaluation of myocardial infarction and regional ventricular performance using technetium-99m hexakis (t-butylisonitrile) technetium (I) (TBI): a new myocardial imaging agent. Eur J Nucl Med. 1986; 12(5-6):219-25. DOI: 10.1007/BF00251973. View

12.

HOLMAN B, Jones A, Davison A, Abrams M, Kirshenbaum J, Tumeh S . A new Tc-99m-labeled myocardial imaging agent, hexakis(t-butylisonitrile)-technetium(I) [Tc-99m TBI]: initial experience in the human. J Nucl Med. 1984; 25(12):1350-5. View

13.

Nishiyama H, Deutsch E, ADOLPH R, Sodd V, Libson K, SAENGER E . Basal kinetic studies of Tc-99m DMPE as a myocardial imaging agent in the dog. J Nucl Med. 1982; 23(12):1093-101. View

14.

Rothendler J, Okada R, Wilson R, Brown K, Boucher C, Strauss H . Effect of a delay in commencing imaging on the ability to detect transient thallium defects. J Nucl Med. 1985; 26(8):880-3. View