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Accuracy of 99mTc-tetrofosmin myocardial tomography in the evaluation of coronary artery disease.

AbstractBACKGROUND:
Technetium 99m-labeled myocardial agents have been proposed as an alternative to thallium 201. The aim of this study was to assess retrospectively the accuracy of exercise myocardial 99mTc-tetrofosmin scintigraphy with tomographic imaging (SPECT) in a large group population in the evaluation of coronary artery disease. Furthermore we evaluated the relation between the severity of scintigraphic impaired myocardial perfusion and the angiographic coronary artery stenoses in patients without myocardial infarction and with stenosis localized exclusively in the proximal segment of the 3 main coronary arteries.
METHODS AND RESULTS:
The study group consisted of 235 consecutive patients, 204 (87%) of whom were men, with a mean age of 57+/-10 years, and with suspected or known coronary artery disease, who underwent 99mTc-tetrofosmin SPECT and coronary angiography. Furthermore, 61 patients in a low-likelihood group for coronary artery disease were also studied. Significant disease was defined by > or = 50% luminal coronary artery stenosis in > or = 1 native coronary artery or major branch or in a saphenous vein graft or arterial mammary graft. The overall sensitivity was 95%, specificity was 76%, and predictive accuracy was 95%. The normalcy rate for the low-likelihood group was 93%. Sensitivity was 71% for the left anterior descending artery, 61% for the left circumflex artery, and 73% for the right coronary artery. Specificity was 94% for the left anterior descending artery, 96% for the left circumflex artery, and 91% for the right coronary artery. Predictive accuracy was 79% for the left anterior descending artery, 78% for the left circumflex artery, and 81 % for the right coronary artery. In patients without myocardial infarction linear regression analysis between scintigraphy and angiography showed a significant correlation in patients with severe proximal coronary artery stenosis (r = 0.53, P < .002), but not in those with moderate proximal stenosis (r = 0.31, P = NS).
CONCLUSIONS:
This study shows that 99mTc-tetrofosmin SPECT is accurate in the detection of coronary artery disease. The relation of the severity of scintigraphic impaired myocardial perfusion and angiographic coronary artery stenosis, however, may differ significantly in patients with proximal stenosis of different severity.
AuthorsS Azzarelli, A R Galassi, R Foti, C Mammana, S Musumeci, G Giuffrida, C Tamburino
JournalJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology (J Nucl Cardiol) 1999 Mar-Apr Vol. 6 Issue 2 Pg. 183-9 ISSN: 1071-3581 [Print] UNITED STATES
PMID10327103 (Publication Type: Journal Article)
Chemical References
  • Organophosphorus Compounds
  • Organotechnetium Compounds
  • Radiopharmaceuticals
  • Thallium Radioisotopes
  • technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane
Topics
  • Aged
  • Coronary Angiography
  • Coronary Artery Bypass
  • Coronary Disease (radiography, radionuclide imaging)
  • Coronary Vessels (radionuclide imaging)
  • Exercise Test
  • Female
  • Heart (radionuclide imaging)
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Middle Aged
  • Organophosphorus Compounds
  • Organotechnetium Compounds
  • Predictive Value of Tests
  • Radiopharmaceuticals
  • Sensitivity and Specificity
  • Thallium Radioisotopes
  • Tomography, Emission-Computed, Single-Photon

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