Comparison of technetium 99m methoxy isobutyl isonitrile and thallium 201 for evaluation of coronary artery disease by planar and tomographic methods

Kiat, Hosen; Maddahi, Jamshid; Roy, Lynne; Train, Kenneth Van; Friedman, John D.; Resser, Kenneth J.; Berman, Daniel S.

doi:10.1016/0002-8703(89)90649-2

Cited by 291 publications

(70 citation statements)

References 21 publications

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“…Among the great deal of studies carried out with MIBI as a perfusional tracer, the few of them which used SPECT obtained results similar to ours, achieving 82-95% sensitivity in the detection of CAD patients [14,32,40], 79-89% regional sensitivity and 72-86% regional specificity [9,22,27].…”

Section: Perfusional Tomogramssupporting

confidence: 76%

“…According to previous investigations [9,[20][21][22], left ventricular segments on functional images, as well as on perfusional tomograms, were related to coronary regions as follows: LAD region included the whole anterior wall, the interventricular septum and the apex; LCx region included the lateral wall, and RCA region (when preponderant) included the inferior and posterobasal wall. Inferolateral and inferoapical wall assignment was modified depending on the vessel corresponding to the neighboring abnormality present.…”

Section: Discussionmentioning

confidence: 99%

“…Although the visual method still represents the most widely used technique for assessing coronary stenosis severity [8,9,20,22,23,27], it introduces an additional level of subjectivity in data analysis, and represents a source of bias, as the use of a rough percent diameter narrowing ignores the full geometric impact of a stenosis on coronary blood flow [33]. Therefore, the true significance of these results needs be confirmed by studies using computer-assisted quantitation of luminal narrowings.…”

Section: Limitations Of the Studymentioning

confidence: 99%

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Single-day combined evaluation of regional myocardial perfusion and function at rest and peak exercise with99mTc-MIBI in patients with coronary artery disease

et al. 1993

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Abstract99mTc-labeled methoxy-isobutyl-isonitrile (MIBI) allows a simultaneous radionuclide assessment of regional heart function and perfusion. In this study the effectiveness of functional and perfusional images obtained with ~gmTc-MIBI in the detection of coronary stenoses was compared with that of their combination.We studied 197 patients who underwent coronary angiography and a single-day radionuclide protocol including first pass angiography (multicrystal gamma camera) and single photon emission computed tomography, by means of 2 injections of 99mTc-MIBI at rest and at peak exercise. Fifteen patients had < 50% stenoses, 50 had 1-vessel, 69 2-vessel and 63 3-vessel disease, for a total of 377 pathological major coronary vessels; 129 patients had previous myocardial infarction. Functional images, perfusional tomograms and their combination showed the same sensitivity (98%) and specificity (80%) in detecting coronary patients. Regional sensitivity and specificity of the combined analysis achieved 87% and 82%, respectively, vs. 94% (p < 0.005) and 60% (p < 0.001) of functional images, and 88% (p = N.S.) and 74% (p < 0.05) of perfusional tomograms.Thus, the combined analysis of regional functional and perfusional abnormalities increased significantly the specificity in the detection of coronary stenoses, in comparison with the separate evaluation of function and perfusion, achieving also a slightly higher diagnostic accuracy (85%, vs. 81% and 83%, respectively). The results confirm that a single-day protocol simultaneously assessing regional myocardial function and perfusion with 99mTc-MIBI represents a rapid and effective diagnostic method, that allows the physician to assess the presence and functional importance of coronary stenoses in less than 4 hours.

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Section: Perfusional Tomogramssupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Limitations Of the Studymentioning

confidence: 99%

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Single-day combined evaluation of regional myocardial perfusion and function at rest and peak exercise with99mTc-MIBI in patients with coronary artery disease

et al. 1993

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“…Finally, the high photon flux and energy of the radiotracer and the lack of significant redistribution makes 99mT~-MIBI more suitable for single photon emission computerized tomography (SPECT) imaging; this technique has showed to have high sensitivity and specificity in the identification of patients with coronary artery disease. [16][17] However, in clinical practice the lack of redistribution of 99mTc-MIBI may represent a relative disadvantage of this form of imaging compared with 201Tl imaging, especially in outpatients, because two injections, generally 24 h apart, are needed in order to differentiate ischemia from scar. Our results showed that a short protocol giving two injections only a few hours apart gave results that are comparable to those obtained when the two injections are separated by 24 h, with a good concordance on a segment-to-segment basis with 201T1.…”

Section: Comparison Between Zoltl and Mtc-mibi Imagingmentioning

confidence: 99%

Diagnostic value of technetium‐99m‐MIBI as a myocardial perfusion imaging agent: Comparison of long and short intervals between rest and stress injections

Magriñá

Bosch

Roig

et al. 1992

Clinical Cardiology

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Summary:To assess the diagnostic value of technetium99m-MIBI (99mTc-MIBI) as a myocardial perfusion imaging agent, and if rest and exercise scans could be performed on the same day, 21 patients with coronary artery disease were studied. Qualitative planar 201-thallium (201Tl) scans, coronary angiography, or both were also performed (median between studies 11 days). In 10 patients an injection of 740 mBq of 99mTc-MIBI at stress was followed by a second injection of 740 mBq at rest 24 h later (long interval) (LI). In 11 patients injection of 370 mBq at rest was followed 3 h later by an injection of 740 mE3q at stress (short interval) (SI). Exercise scans were performed to similar maximal work load (LI = 6.6 k 1.8 METs; SI=6.3+1.7 METs; 201T1=6.8f1.2 METs; p=NS) and double product (LI= 19551 f7370; SI= 19900k6797; 201Tl = 19965 f 5282; p = NS). Overall, 99mTc-MIBI and *OIT1 agreed in 92% of the patients tested and in 165 of 180 (92%) left ventricular segments in both 99mTc-MIBI protocols using short and long intervals between injections. In 15 patients with significant stenosis, 99mTc-MIBI correctly identified 13 patients (sensitivity of 87%). Thus, 99mTc-MIBI is a useful imaging agent with similar diagnostic value as 201T1. In spite of its lack of myocardial redistribution, wmTc-MIBI rest and exercise scans performed on the same day seem to have a similar concordance rate with 201Tl as when performed on separate days.

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“…The accuracy of the two techniques to detect CAD has also been shown to be equal. (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) Advantages of using the Tc-99m agent include better image quality and the ability to simultaneously assess left ventricular function. (5,6) The prognostic signifi cance of a normal stress-redistribution Tl-201 myocardial perfusion study in patients with known or suspected CAD is well documented, showing a benign outcome in such patients over the short-and long-term, with an overall cardiac event rate of less than 1% per year.…”

Section: Introductionmentioning

confidence: 99%

The prognostic signifi cance of normal technetium-99m MIBI myocardial perfusion spect imaging over a four-year follow-up period

Neethling

Heerden

Klopper

et al. 2017

SAHJ

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Comparison of technetium 99m methoxy isobutyl isonitrile and thallium 201 for evaluation of coronary artery disease by planar and tomographic methods

Cited by 291 publications

References 21 publications

Single-day combined evaluation of regional myocardial perfusion and function at rest and peak exercise with99mTc-MIBI in patients with coronary artery disease

Single-day combined evaluation of regional myocardial perfusion and function at rest and peak exercise with99mTc-MIBI in patients with coronary artery disease

Diagnostic value of technetium‐99m‐MIBI as a myocardial perfusion imaging agent: Comparison of long and short intervals between rest and stress injections

The prognostic signifi cance of normal technetium-99m MIBI myocardial perfusion spect imaging over a four-year follow-up period

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