BACKGROUND: The aim of this study was to determine the variability in myocardial activity with 99mTc-labeled sestamibi and 201Tl tomographic imaging, and to correlate this variability with patient anthropometric data and type of stress. METHODS AND RESULTS: Conventional tomographic acquisition (all-purpose collimator, 30 views, 40 sec/view) was performed in 249 patients (155 with 99mTc-sestamibi, 84 with 201Tl). Normal myocardium was identified in three short-axis tomographic slices between the base and mid-ventricle. To exclude abnormal myocardium, all myocardial activity below an 85% threshold of peak counts was excluded. The average counts per pixel in the remaining myocardium was determined. All data were normalized to a collimator sensitivity of 8.1 counts/min/kBq and corrected for decay. Myocardial count densities in both 201Tl and 99mTc-sestamibi studies exhibited a high degree of variability and varied by factors of 3 to 4 and 2.5 to 3 respectively, between the 10th and 90th percentile of count densities. All 99mTc-sestamibi studies showed an inverse correlation (R approximately 0.7) between myocardial count density and patient weight. For stress 201Tl studies in male patients, a similar inverse correlation (R = 0.63) was found between patient weight and myocardial count density. No correlation was found for female patients. For rest 99mTc-sestamibi studies, the average myocardial count density was 1245 +/- 297 counts/pixel for a 1.11 GBq (30 mCi) injection. This was similar with pharmacologic stress (1224 +/- 297 counts/pixel per 1.11 GBq (30 mCi), but significantly higher with exercise (1569 +/- 363 counts/pixel per 1.11 GBq (30 mCi) (p < 0.005). 201Tl studies averaged 327 +/- 97 counts/pixel (111 MBq [3 mCi] injection) with exercise and 374 +/- 145 counts/pixel/111 MBq (3 mCi) with pharmacologic stress (p = NS). Redistribution studies after exercise/pharmacologic stress (with a 37 MBq [1 mCi] reinjection) averaged 267 +/- 83 counts/pixel (148 MBq [3+1 mCi]). CONCLUSIONS: Measured count densities in the myocardium demonstrate a high degree of variability that is only weakly correlated with patient anthropometric data. Nevertheless, knowledge of the mean values of myocardial activity as a function of administered dose may be useful in the optimization of rapid imaging procedures for 99mTc-based perfusion agents.
BACKGROUND: The aim of this study was to determine the variability in myocardial activity with 99mTc-labeled sestamibi and 201Tl tomographic imaging, and to correlate this variability with patient anthropometric data and type of stress. METHODS AND RESULTS: Conventional tomographic acquisition (all-purpose collimator, 30 views, 40 sec/view) was performed in 249 patients (155 with 99mTc-sestamibi, 84 with 201Tl). Normal myocardium was identified in three short-axis tomographic slices between the base and mid-ventricle. To exclude abnormal myocardium, all myocardial activity below an 85% threshold of peak counts was excluded. The average counts per pixel in the remaining myocardium was determined. All data were normalized to a collimator sensitivity of 8.1 counts/min/kBq and corrected for decay. Myocardial count densities in both 201Tl and 99mTc-sestamibi studies exhibited a high degree of variability and varied by factors of 3 to 4 and 2.5 to 3 respectively, between the 10th and 90th percentile of count densities. All 99mTc-sestamibi studies showed an inverse correlation (R approximately 0.7) between myocardial count density and patient weight. For stress 201Tl studies in male patients, a similar inverse correlation (R = 0.63) was found between patient weight and myocardial count density. No correlation was found for female patients. For rest 99mTc-sestamibi studies, the average myocardial count density was 1245 +/- 297 counts/pixel for a 1.11 GBq (30 mCi) injection. This was similar with pharmacologic stress (1224 +/- 297 counts/pixel per 1.11 GBq (30 mCi), but significantly higher with exercise (1569 +/- 363 counts/pixel per 1.11 GBq (30 mCi) (p < 0.005). 201Tl studies averaged 327 +/- 97 counts/pixel (111 MBq [3 mCi] injection) with exercise and 374 +/- 145 counts/pixel/111 MBq (3 mCi) with pharmacologic stress (p = NS). Redistribution studies after exercise/pharmacologic stress (with a 37 MBq [1 mCi] reinjection) averaged 267 +/- 83 counts/pixel (148 MBq [3+1 mCi]). CONCLUSIONS: Measured count densities in the myocardium demonstrate a high degree of variability that is only weakly correlated with patient anthropometric data. Nevertheless, knowledge of the mean values of myocardial activity as a function of administered dose may be useful in the optimization of rapid imaging procedures for 99mTc-based perfusion agents.
Authors: R J Gibbons; M S Verani; T Behrenbeck; P A Pellikka; M K O'Connor; J J Mahmarian; J H Chesebro; F J Wackers Journal: Circulation Date: 1989-11 Impact factor: 29.690
Authors: John J Ryan; Rupa Mehta; Thejasvi Thiruvoipati; R Parker Ward; Kim Allan Williams Journal: J Nucl Cardiol Date: 2012-01-19 Impact factor: 5.952
Authors: J D van Dijk; P L Jager; J P Ottervanger; J de Boer; A H J Oostdijk; E M Engbers; C H Slump; S Knollema; J A van Dalen Journal: J Nucl Cardiol Date: 2015-09-09 Impact factor: 5.952