Myocardial Tracer Uptake in SPECT Images after Direct Intracoronary Injection Of Tl-201: Comparison with Stress-Reinjection Images.
- Author:
Ji Hyoung SEO
1
;
Seong Min KANG
;
Jin Ho BAE
;
Yong Jin LEE
;
Sang Woo LEE
;
Jeongsoo YOO
;
Byeong Cheol AHN
;
Yong Geun CHO
;
Jaetae LEE
Author Information
1. Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, Korea. jaetae@knu.ac.kr
- Publication Type:Original Article
- Keywords:
coronary artery disease;
intracoronary Tl-201 injection;
myocardial perfusion SPECT;
myocardial viability
- MeSH:
Adenosine;
Angiography;
Coronary Artery Disease;
Coronary Vessels;
Echocardiography;
Humans;
Myocardial Infarction;
Myocardium;
Perfusion;
Tomography, Emission-Computed, Single-Photon*
- From:Nuclear Medicine and Molecular Imaging
2007;41(4):291-298
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To investigate the feasibility of Tl-201 SPECT with intracoronary injection (IC-I) in the detection of viable myocardium, we have performed SPECT imaging after direct intracoronary injection of Tl-201 and images were compared with those of stress-reinjection (Re-I) SPECT. METHODS: Fourteen coronary artery disease patients (male 11, mean age 54 years) who had myocardial infarction or demonstrated left ventricular wall motion abnormality on echocardiography were enrolled. Three mCi of Tl-201 was injected into both coronary arteries during angiography and images were acquired between 6- and 24-hour after injection. Reinjection imaging with 1 mCi of Tl-201 was performed at 4-hour after adenosine stress imaging with 3 mCi of Tl-201. Images were interpreted according to 4-grade visual scoring system (grade 0-3). Segments with mild to moderated uptake (< or=grade 1), and upgraded more than one score with reinjection, and were defined as viable myocardium. RESULTS: Image quality was poor in two cases with IC-I. Numbers of non-viable segments were 60 (23.8%) with IC-I, and 38 (15.1%) with Re-I, respectively. Overall agreement for perfusion grade per myocardial segment in each IC-I and Re-I was 76.5%. Overall agreement for viable segment between IC-I and Re-I was 90.5%. Only one out of 38 segments interpreted as non-viable with Re-I were interpretated as viable with IC-I. And 23 out of 214 segments interpreted as viable with Re-I were interpreted as non-viable with IC-I. CONCLUSION: Intracoronary Tl-201 SPECT seemed to be not advantageous over stress-rest reinjection imaging in the assessment of myocardial viability, mainly due to low count statistics at 6-hour or 24-hour delayed time points. The feasibility of intracoronary Tl-201 SPECT is considered to be limited.
