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Assessment of myocardial perfusion and viability with technetium-99m methoxyisobutylisonitrile and thallium-201 rest redistribution in chronic coronary artery disease

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Abstract

We compare thallium-201 rest redistribution and fluorine-18 fluorodeoxyglucose ([18F]FDG) for the assessment of myocardial viability within technetium-99m methoxyisobutylisonitrile (MIBI) perfusion defects in 27 patients with chronic stable coronary artery disease. The following studies were performed: (1) stress99mTc-MIBI, (2) rest99mTc-MIBI, (3)201T1 rest-redistribution single-photon emission tomography, (4) [18F]FDG positron emission tomography. The left ventricle was devided into 11 segments on matched tomographic images. The segment with the highest activity at stress was taken as the reference (activity=100%). Perfusion defects at99mTc-MIBI rest were classified as severe (activity<50%), moderate (activity 50%–60%) or mild (activity 60%–85%). Uptakes of [18F]FDG and rest-redistributed201Tl were recognized as significant if they exceeded 50% of that in the reference segment. Among the 33 segments with severe99mTc-MIBI rest perfusion defects, 21 had significant [18F]FDG and 10 significant rest-redistributed201Tl uptake. As regards the 37 segments with moderate defects, [18F]FDG was present in 29 and201Tl in 31, while of the 134 segments with mild defects, 128 showed [18F]FDG uptake, and 131,201Tl uptake. In conclusion, there is an inverse relationship between the severity of99mTc-MIBI perfusion defects and the uptake of rest-redistributed201Tl and [18F]FDG. Both tracers are adequate markers of viability in mild and moderate defects; in severe defects201Tl might underestimate the presence of viability as assessed by [18F]FDG.

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Authors and Affiliations

  1. INB-CNR, University of Milan, Institute H San Raffaele, Milan, Italy

    C. Rossetti, C. Landoni, G. Lucignani, G. Huang, A. Margonato, S. Chierchia, L. Galli, A. Savi & F. Fazio

  2. Institute of Cardiology, University of Milan, CNR, “I. Monzino” Foundation, Milan, Italy

    A. L. Bartorelli & M. D. Guazzi

Authors
  1. C. Rossetti
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  2. C. Landoni
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  3. G. Lucignani
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  4. G. Huang
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  5. A. L. Bartorelli
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  6. M. D. Guazzi
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  7. A. Margonato
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  8. S. Chierchia
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  9. L. Galli
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  10. A. Savi
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  11. F. Fazio
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Rossetti, C., Landoni, C., Lucignani, G. et al. Assessment of myocardial perfusion and viability with technetium-99m methoxyisobutylisonitrile and thallium-201 rest redistribution in chronic coronary artery disease. Eur J Nucl Med 22, 1306–1312 (1995). https://doi.org/10.1007/BF00801618

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  • DOI: https://doi.org/10.1007/BF00801618

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