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KMID : 1148920070410040291
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Nuclear Medicine and Molecular Imaging
2007 Volume.41 No. 4 p.291 ~ p.298
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Myocardial Tracer Uptake in SPECT Images after Direct Intracoronary Injection Of Tl-201: Comparison with Stress-Reinjection Images
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Seo ji-Hyoung
Ahn Byung-Cheol
Kang Sung-Min
Bae Jin-Ho
Lee Sang-Woo
Yoo Jeong-soo
Lee Jae-Tae
Cho Yong-Keun
Lee Yong-Jin
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Abstract
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Purpose: To investigate the feasibility of Tl-201 SPECT with intracoronary injection (IC-I) in the detection of viable myocardium, we have performed SPECT imaging after direct intracoronary injection of Tl-201 and images were compared with those of stress-reinjection (Re-I) SPECT.
Methods: Fourteen coronary artery disease patients (male 11, mean age 54 years) who had myocardial infarction or demonstrated left ventricular wall motion abnormality on echocardiography were enrolled. Three mCi of Tl-201 was injected into both coronary arteries during angiography and images were acquired between 6- and 24-hour after injection. Reinjection imaging with 1 mCi of Tl-201 was performed at 4-hour after adenosine stress imaging with 3 mCi of Tl-201. Images were interpreted according to 4-grade visual scoring system (grade 0-3). Segments with mild to moderated uptake (≤grade 1), and upgraded more than one score with reinjection, and were defined as viable myocardium.
Results: Image quality was poor in two cases with IC-I. Numbers of non-viable segments were 60 (23.8%) with IC-I, and 38 (15.1%) with Re-I, respectively. Overall agreement for perfusion grade per myocardial segment in each IC-I and Re-I was 76.5%. Overall agreement for viable segment between IC-I and Re-I was 90.5%. Only one out of 38 segments interpreted as non-viable with Re-I were interpretated as viable with IC-I. And 23 out of 214 segments interpreted as viable with Re-I were interpreted as non-viable with IC-I.
Conclusion: Intracoronary Tl-201 SPECT seemed to be not advantageous over stress-rest reinjection imaging in the assessment of myocardial viability, mainly due to low count statistics at 6-hour or 24-hour delayed time points. The feasibility of intracoronary Tl-201 SPECT is considered to be limited. (Nucl Med Mol Imaging 2007;41(4):291-298)
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KEYWORD
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coronary artery disease, intracoronary Tl-201 injection, myocardial perfusion SPECT, myocardial viability
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