Increased Prognostic Value of Combined Myocardial Perfusion SPECT Imaging and the Quantification of Lung Tl-201 Uptake

Abstract

These findings suggest a benign prognosis in patients with normal SPECT (regardless of the L:H ratio). Conversely, all patients with ischemia are at high risk for future cardiac events. Quantification of the Tl-201 lung uptake seems to be valuable in evaluations of disease prognosis, especially in patients with fixed defects.

Transient ischemic dilation ratio of the left ventricle is a significant predictor of future cardiac events in patients with otherwise normal myocardial perfusion SPECT

“…Transient ischemic dilation of the LV and increased lung-heart ratio (LHR) are both associated with severe CAD (13-16,30 -32). Increased LHR with 201 Tl has been shown to be valuable in evaluation of prognosis in patients with myocardial perfusion abnormalities (33,34), but does not appear to risk-stratify patients with normal MPS (33,35). A number of clinical studies have demonstrated in multiple settings that the presence of TID on MPS predicts left main or severe multivessel CAD (13,14,36 -40) or adverse cardiac outcome (18,41).…”

Prognostic value of myocardial perfusion scintigraphy for patients suspected of and diagnosed with coronary artery disease

“…A number of patients with pathological results underwent no revascularisation or even coronary angiography, thus it can be considered an assessment of the natural course of the disease. Kamianek et al suggested that it would be useful to include an additional parameter, such as pulmonary uptake [19].…”

Sensitivity and specificity of stress cardiac gated SPECT imaging in the detection of coronary artery disease: validation of findings by coronary angiography.

“…), je nepřímou známkou dysfunkce levé komory srdeční a pojí se s vyšším rizikem kardiální příhody. (11,12) V současné éře stále častějšího užití 99m Tc značených radiofarmak (MIBI a tetrofosmin) však přicházíme o možnost zjištění plicní koncentrace radiofarmaka. Máme však k dispozici další důležitý parametr -poměr tranzientní ischemické dilatace (TID), který je kalkulován z "ungated" obrazů perfuze jako poměr velikosti dutiny levé komory po zátěži a v klidu.…”