Myocardial scintigraphy with iodine-123 phenylpentadecanoic acid and thallium-201 in patients with coronary artery disease: a comparative dual-isotope study.

Abstract

To characterise the clinical usefulness of serial myocardial scintigraphy with iodine-123 phenylpentadecanoic acid (IPPA) in comparison with thallium-201, dual-isotope investigations were performed in 41 patients with angiographically documented coronary artery disease. Both tracers were administered simultaneously during symptom-limited ergometry. Planar scintigrams were acquired immediately after stress, and delayed imaging was performed after 1 h for IPPA and 4 h for 201Tl. Scintigrams were evaluated both qualitatively and quantitatively using a newly developed algorithm for automated image superposition. Initial myocardial uptake of both tracers was closely correlated (r = 0.75, p < 0.001). Both tracers also revealed a similar sensitivity for the identification of individual coronary artery stenoses > or = 75% (IP-PA: 70.0%, 201Tl: 66.3%, P = NS) with identical specificity (69.8%). The number of persistent defects, however, was significantly higher with IPPA (P = 0.021), suggesting that visual analysis of serial IPPA scintigrams may overestimate the presence of myocardial scar tissue. On the other hand, previous Q wave myocardial infarction was associated with a decreased regional IPPA clearance (29% +/- 11% vs 44% +/- 11% in normal myocardium, P < 0.05). The data indicate that serial myocardial scintigraphy with IPPA is essentially as sensitive as scintigraphy with 201Tl for the detection of stress-induced perfusion abnormalities. Quantitative analysis of myocardial IPPA kinetics, however, is required for the evaluation of tissue viability.

• Authors: R Zimmermann, B Rauch, M Kapp, B Bubeck, F J Neumann, F Seitz, P Stokstad, G Mall, H Tillmanns, W Kübler
• Journal: European journal of nuclear medicine (Eur J Nucl Med) Vol. 19 Issue 11 Pg. 946-54 ( 1992) ISSN: 0340-6997 [Print] Germany
• PMID: 1425781 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Iodine Radioisotopes
• Iodobenzenes
• Thallium Radioisotopes
• omega-(4-iodophenyl)pentadecanoic acid

Topics

• Algorithms
• Coronary Disease (diagnostic imaging)
• Exercise Test
• Female
• Heart (diagnostic imaging)
• Humans
• Image Processing, Computer-Assisted
• Iodine Radioisotopes
• Iodobenzenes
• Male
• Middle Aged
• Radionuclide Imaging
• Sensitivity and Specificity
• Thallium Radioisotopes
• Time Factors