Myocardial SPET imaging with 99Tcm-tetrofosmin in clinical practice

Eck-Smit, Berthe L. F. van; Poots, S.; Zwinderman, A. H.; Bruschke, A. V. G.; Pauwels, E. K. J.; Wall, E. E. van der

doi:10.1097/00006231-199701000-00006

Cited by 17 publications

(6 citation statements)

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“…In other patients, a pharmacological stress test [the intravenous administration of adenosine (0.14 mg/kg/minute for 6 minutes) or dobutamine (up to a maximum dose of 40 μg/kg/minute in 15 minutes) until the required age‐related heart rate was reached] was performed. The test protocol was carried out with a 1‐day protocol until 2002, and after that, a 2‐day protocol was employed; the 2 protocols were fully compatible 16. Beta‐blockers and calcium antagonists were discontinued for 24 hours before 99m Tc‐tetrofosmin SPECT.…”

Section: Methodsmentioning

confidence: 99%

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et al. 2008

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Section: Methodsmentioning

confidence: 99%

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et al. 2008

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“…In the 2-day protocol, 500 MBq 99m Tc-tetrofosmin was administered 45-60 min prior to rest and 30-45 min prior to stress image acquisition [18]. Image data were acquired using a triple-head Toshiba GCA 9300 gamma camera applying a step and shoot method (4°/step, 90 projections, 35 s per frame, 64×64 matrix).…”

Section: Methodsmentioning

confidence: 99%

Detection of residual wall motion after myocardial infarction by gated technetium-99m tetrofosmin SPET: a comparison with contrast ventriculography

et al. 2001

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The differentiation of residual viability from necrotic myocardium in patients with a prior myocardial infarction is important when deciding whether revascularization is indicated. Myocardial viability can be assessed by studying perfusion and regional wall motion. Gated single-photon emission tomography (SPET) imaging allows the simultaneous assessment of perfusion and function through a single study. The aim of this study was to analyse the concordance between wall motion score derived by gated SPET and by contrast ventriculography. Furthermore, the agreement between myocardial perfusion and regional myocardial wall motion was analysed for both techniques. We studied a homogeneous group of 26 consecutive patients with a prior myocardial infarction, using both gated technetium-99m tetrofosmin SPET and contrast ventriculography. A seven-segment model of the left ventricle was employed to score regional myocardial wall motion on images obtained with gated SPET and contrast ventriculography using a four-point scale. Contrast ventriculography was performed within 2 weeks of the gated SPET study. Prevalence of abnormal wall motion (akinetic or dyskinetic) was 24/182 (13%) for gated SPET and 25/182 (14%) for contrast ventriculography (P = NS). There was a high agreement (80%) in wall motion score between gated SPET and contrast ventriculography (kappa = 0.67, P < 0.001). The agreement was better in segments with normal or mild to moderate hypoperfusion (82%, kappa = 0.69) than in those with severe hypoperfusion (67%, kappa = 0.56). The agreement between myocardial perfusion and myocardial wall motion was 89% (162/182), kappa = 0.57, for gated SPET and 80% (145/182), kappa = 0.21, for contrast ventriculography. The relation between the summed wall motion scores per patient on gated SPET and contrast ventriculography was excellent (y = 0.81x + 2.9, r = 0.82, P < 0.01). Thirteen (43%) out of 30 segments with severely diminished or no myocardial perfusion showed normal or hypokinetic wall motion on gated SPET, suggesting residual myocardial viability in malperfused regions. Our results suggest that gated SPET imaging is a reliable tool for the assessment of regional wall motion in post-myocardial infarction patients. Furthermore, in patients with a previous myocardial infarction, gated SPET imaging has the potential to detect preserved wall motion in regions with fixed perfusion defects, which might be indicative of residual myocardial viability.

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“…Patients who were unable to perform a physical stress test or patients with a left bundle branch block underwent a pharmacological stress test as described previously. 15 Vasodilatation was induced using intravenous administration of adenosine at a dose rate of 0.14 mg/kg/min for 6 minutes. Technetium-99m tetrofosmin was injected 3 minutes after start of infusion of the pharmacological agent.…”

Section: Stress Myocardial Perfusion Protocolmentioning

confidence: 99%

“…15 A dose of 500 MBq technetium-99m tetrofosmin was given intravenously for the 2-day protocol stress study and 750 MBq for the 1-day protocol stress study. Dosages of 500 and 250 MBq, respectively, were given for the rest study.…”

Section: Gated Spect Acquisition Protocolmentioning

confidence: 99%

The additive prognostic value of perfusion and functional data assessed by quantitative gated SPECT in women

America

Bax

Boersma

et al. 2009

Journal of Nuclear Cardiology

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Background. The aim of this study was to assess the prognostic value of technetium-99m tetrofosmin gated SPECT imaging in women using quantitative gated single photon emission computed tomography (SPECT) imaging.Methods. We followed 453 consecutive female patients. Average follow-up was 1.33 years (max. 2.55). Hard endpoints were cardiac death, acute myocardial infarction, or documented ventricular fibrillation. Event-free survival curves were obtained. Optimal cutoff values for left ventricular (LV) volumes, LV ejection fraction (LVEF), and perfusion data to predict outcome were determined by ROC curve analysis.Results. A total of 236 patients had an abnormal study, of whom 27 patients experienced hard events (16 deaths) and 47 patients soft events. For hard events summed stress score (SSS) and LVEF, and for any cardiac event SSS showed independent incremental prognostic value. The survival curves were maximally separated when using cutoff values for SSS of ‡22 and LVEF < 52% (P < 0.001, HR 4.61 and P < 0.001 HR 5.24 for SSS and LVEF resp.), and SSS ‡ 14 (P < 0.001 HR 3.76) for any cardiac event.Conclusion. In women, perfusion and functional parameters derived from quantitative gated technetium-99m tetrofosmin SPECT imaging can adequately be used for cardiac risk assessment. Using quantitative gated SPECT, female patients with an LVEF < 52% or an SSS ‡ 22 are at increased risk for subsequent hard events. Furthermore, patients with an SSS ‡ 14 are at increased risk for any cardiac events. (J Nucl Cardiol 2009;16:10-9)

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Myocardial SPET imaging with 99Tcm-tetrofosmin in clinical practice

Cited by 17 publications

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Detection of residual wall motion after myocardial infarction by gated technetium-99m tetrofosmin SPET: a comparison with contrast ventriculography

The additive prognostic value of perfusion and functional data assessed by quantitative gated SPECT in women

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