Quantitative rotational thallium-201 tomography for identifying and localizing coronary artery disease.

Abstract

The purpose of this study was to develop and validate a method for quantifying the uptake, redistribution, and washout of thallium-201 (201T1) obtained with rotational tomography. This method generates maximum count circumferential profiles of the short-axis slices of the left ventricle, translates them into polar coordinate profiles, and displays them as a bullseye plot, which consists of a series of concentric circles with the apex at the center and the base at the periphery. Normal limits were established for the distribution of°0T1 in 36 patients with a low (<5%) probability of coronary artery disease (CAD). Forty-five patients who had undergone coronary angiography were used as a pilot group to define criteria for the identification and localization of perfusion defects. The best agreement with the results of angiography was found when abnormal regions of the bullseye were defined as contiguous defects over 2.5 SDs below normal. These criteria were applied prospectively to 210 points (179 points with >50% diameter stenosis and 31 with <50%). Visual, quantitative, and combined visual and quantitative analysis were compared for overall detection of disease and for detection of individual vessel involvement. The overall sensitivity for detection of disease by these methods was 97%, 95%, and 95%, respectively. The specificities were 68%, 74%, and 71% respectively. The sensitivity for detection of individual vessel involvement with the bullseye alone was 78% for the left anterior descending artery (LAD), 89% for the right coronary artery (RCA), and 65% for the left circumflex (LCx). For visual analysis, the results were 70%, 88%, and 50%, respectively, while the use of visual and quantitative analysis combined identified 75% of LAD, 87% of RCA, and 55%

Perfusión y función ventricular en SPECT cardiaco y coronariografía del mismo día según localización en enfermedad de un vaso

“…A este respecto es interesante destacar el trabajo de De Pasquale EE et al 10 , quienes vieron que la sensibilidad para la detección de compromiso de un vaso coronario, sólo con el bullseye fue 78% para la ADA, 89% para la arteria coronaria derecha y 65% para la circunfleja.…”

Identification of proximal left anterior descending artery stenosis with thallium-201 defect patterns in patients with angina pectoris

“…The results showed that in patients with angina pectoris, proximal LAD stenosis can be predicted with reliable accuracy by recognizing defect patterns. Polar map displays were useful because they allowed more objective and simultaneous visual evaluation of the whole myocardium, 6,10 but evaluation of tomographic images was also necessary to avoid false-positive interpretations. 11 By using proximal LAD patterns on a polar map, proximal LAD stenosis could be detected with a sensitivity of 72% and a high specificity of 95%.…”

“…Thus, a widely available noninvasive test that can identify proximal LAD stenosis could have substantial clinical utility. Thallium-201 single-photon emission computed tomography (SPECT) is widely utilized to evaluate myocardial ischemia, 6,7 and the location and pattern of perfusion defects often implicates which coronary artery is likely to be responsible. 8 However, the ability of thallium-201 SPECT findings for identifying proximal LAD stenosis has not been thoroughly evaluated.…”

Characteristics and outcome of octogenarian population referred for myocardial perfusion imaging: Comparison with non-octogenarian population with reference to gender

“…Filling defects were diagnosed as ischemia when the two contiguous slices showed reversibility or when bull's-eye mapping showed a decrease in the intensity of perfusion defects of more than 10% in the redistribution phase. 16,17 …”