Quantitative Evaluation of Myocardial Stress/Rest 201TISPECT: Results of a ROI-Based Method in 108 Patients with CHD

Abstract

ROI-based polar maps (33 ROIs) were employed to evaluate quantitatively stress/rest myocardial 201TI SPECT in 108 patients with angiographically proven coronary heart disease (CHD) in comparison with 30 controls. Sensitivity in detecting a CHD with stenoses of > 50% of luminal diameter was determined versus normal regional values (± 2.5 SD) employing vitality (VI) and wash-out corrected redistribution (RD). The method was evaluated referring to the severity of the disease, to the number of ROIs displaying changes [(a) 1 ROI, (b) >2 ROIs], to validity of VI, RD or a combination thereof, and for specificity. Wash-out values were found to depend on degree of stress individually achieved and thus were not used as a threshold criterion. Sensitivity in supply areas with old myocardial infarctions was 95% (a) and 86% (b), resp. With no infarction, it was 96% (a) and 79% (b), resp. VI in stenosis > 75% was more sensitive than RD. However, combined evaluation of VI and RD yielded sensitivities from 91-100% (a) and 77-94% (b), resp. for different main supply areas. In stenosis < 50% with normal VI, RD was positive in 18-31 %. Specificity turned out to be 91 % (a) and 97% (b), resp. We conclude that the method presented is reliable to quantify numerically 201TI kinetics in myocardial SPECT, aimed at detecting and describing CHD.