Quantitative rotational tomography with 201Tl and 99mTc 2-methoxy-isobutyl-isonitrile: A direct comparison in normal individuals and patients with coronary artery disease

J. K. Kahn, I. McGhie, M. S. Akers, M. N. Sills, T. L. Faber, P. V. Kulkarni, J. T. Willerson, J. R. Corbett

Research output: Contribution to journalArticle

192 Citations (Scopus)

Abstract

We tested the hypothesis that 99mTc 2-methoxy-isobutyl-isonitrile (99mTc MIBI), a new radiopharmaceutical for myocardial perfusion imaging, provides accurate noninvasive detection of coronary artery disease (CAD). Imaging in patients after exercise and at rest with 99mTc MIBI was compared with imaging after exercise and redistribution with 201Tl in 12 normal subjects and 38 patients with angiographic documentation of CAD (≥ 50% diameter stenosis). We used single-photon emission computed tomography (SPECT) and computer quantitation of regional tracer distribution. The quality of reconstructed images with 99mTc MIBI judged visually was superior to that of 201Tl in 88% of all studies performed and was comparable in the others. With the limits of normal as 2.5 SD below the mean of gender-matched normal volunteers, 201Tl SPECT identified 32 and 99mTc MIBI identified 36 patients with CAD (p = 0.2). 201Tl SPECT identified 45 of 75 (60%) and 99mTc MIBI identified 59 of 75 (79%) stenosed coronary arteries (p < 0.05). The quantitative severity of perfusion defects was similar for the two tracers. 201Tl SPECT identified 104 reversibly ischemic myocardial segments compared with 134 with 99mTc MIBI (p < 0.05). Thus, SPECT myocardial perfusion imaging with 99mTc MIBI and computer quantitation provides an accurate method for the noninvasive detection of significant coronary artery disease. Furthermore, image quality is generally superior to 201Tl, and reversibly ischemic myocardial segments may be better identified with 99mTc MIBI.

Original languageEnglish (US)
Pages (from-to)1282-1293
Number of pages12
JournalCirculation
Volume79
Issue number6
StatePublished - 1989

Fingerprint

Single-Photon Emission-Computed Tomography
Coronary Artery Disease
Tomography
Myocardial Perfusion Imaging
Exercise
Radiopharmaceuticals
Documentation
Coronary Vessels
Healthy Volunteers
Pathologic Constriction
Perfusion

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Kahn, J. K., McGhie, I., Akers, M. S., Sills, M. N., Faber, T. L., Kulkarni, P. V., ... Corbett, J. R. (1989). Quantitative rotational tomography with 201Tl and 99mTc 2-methoxy-isobutyl-isonitrile: A direct comparison in normal individuals and patients with coronary artery disease. Circulation, 79(6), 1282-1293.

Quantitative rotational tomography with 201Tl and 99mTc 2-methoxy-isobutyl-isonitrile : A direct comparison in normal individuals and patients with coronary artery disease. / Kahn, J. K.; McGhie, I.; Akers, M. S.; Sills, M. N.; Faber, T. L.; Kulkarni, P. V.; Willerson, J. T.; Corbett, J. R.

In: Circulation, Vol. 79, No. 6, 1989, p. 1282-1293.

Research output: Contribution to journalArticle

Kahn, JK, McGhie, I, Akers, MS, Sills, MN, Faber, TL, Kulkarni, PV, Willerson, JT & Corbett, JR 1989, 'Quantitative rotational tomography with 201Tl and 99mTc 2-methoxy-isobutyl-isonitrile: A direct comparison in normal individuals and patients with coronary artery disease', Circulation, vol. 79, no. 6, pp. 1282-1293.
Kahn, J. K. ; McGhie, I. ; Akers, M. S. ; Sills, M. N. ; Faber, T. L. ; Kulkarni, P. V. ; Willerson, J. T. ; Corbett, J. R. / Quantitative rotational tomography with 201Tl and 99mTc 2-methoxy-isobutyl-isonitrile : A direct comparison in normal individuals and patients with coronary artery disease. In: Circulation. 1989 ; Vol. 79, No. 6. pp. 1282-1293.
@article{495843f3dadc4dacb6c9a489227c93a0,
title = "Quantitative rotational tomography with 201Tl and 99mTc 2-methoxy-isobutyl-isonitrile: A direct comparison in normal individuals and patients with coronary artery disease",
abstract = "We tested the hypothesis that 99mTc 2-methoxy-isobutyl-isonitrile (99mTc MIBI), a new radiopharmaceutical for myocardial perfusion imaging, provides accurate noninvasive detection of coronary artery disease (CAD). Imaging in patients after exercise and at rest with 99mTc MIBI was compared with imaging after exercise and redistribution with 201Tl in 12 normal subjects and 38 patients with angiographic documentation of CAD (≥ 50{\%} diameter stenosis). We used single-photon emission computed tomography (SPECT) and computer quantitation of regional tracer distribution. The quality of reconstructed images with 99mTc MIBI judged visually was superior to that of 201Tl in 88{\%} of all studies performed and was comparable in the others. With the limits of normal as 2.5 SD below the mean of gender-matched normal volunteers, 201Tl SPECT identified 32 and 99mTc MIBI identified 36 patients with CAD (p = 0.2). 201Tl SPECT identified 45 of 75 (60{\%}) and 99mTc MIBI identified 59 of 75 (79{\%}) stenosed coronary arteries (p < 0.05). The quantitative severity of perfusion defects was similar for the two tracers. 201Tl SPECT identified 104 reversibly ischemic myocardial segments compared with 134 with 99mTc MIBI (p < 0.05). Thus, SPECT myocardial perfusion imaging with 99mTc MIBI and computer quantitation provides an accurate method for the noninvasive detection of significant coronary artery disease. Furthermore, image quality is generally superior to 201Tl, and reversibly ischemic myocardial segments may be better identified with 99mTc MIBI.",
author = "Kahn, {J. K.} and I. McGhie and Akers, {M. S.} and Sills, {M. N.} and Faber, {T. L.} and Kulkarni, {P. V.} and Willerson, {J. T.} and Corbett, {J. R.}",
year = "1989",
language = "English (US)",
volume = "79",
pages = "1282--1293",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Quantitative rotational tomography with 201Tl and 99mTc 2-methoxy-isobutyl-isonitrile

T2 - A direct comparison in normal individuals and patients with coronary artery disease

AU - Kahn, J. K.

AU - McGhie, I.

AU - Akers, M. S.

AU - Sills, M. N.

AU - Faber, T. L.

AU - Kulkarni, P. V.

AU - Willerson, J. T.

AU - Corbett, J. R.

PY - 1989

Y1 - 1989

N2 - We tested the hypothesis that 99mTc 2-methoxy-isobutyl-isonitrile (99mTc MIBI), a new radiopharmaceutical for myocardial perfusion imaging, provides accurate noninvasive detection of coronary artery disease (CAD). Imaging in patients after exercise and at rest with 99mTc MIBI was compared with imaging after exercise and redistribution with 201Tl in 12 normal subjects and 38 patients with angiographic documentation of CAD (≥ 50% diameter stenosis). We used single-photon emission computed tomography (SPECT) and computer quantitation of regional tracer distribution. The quality of reconstructed images with 99mTc MIBI judged visually was superior to that of 201Tl in 88% of all studies performed and was comparable in the others. With the limits of normal as 2.5 SD below the mean of gender-matched normal volunteers, 201Tl SPECT identified 32 and 99mTc MIBI identified 36 patients with CAD (p = 0.2). 201Tl SPECT identified 45 of 75 (60%) and 99mTc MIBI identified 59 of 75 (79%) stenosed coronary arteries (p < 0.05). The quantitative severity of perfusion defects was similar for the two tracers. 201Tl SPECT identified 104 reversibly ischemic myocardial segments compared with 134 with 99mTc MIBI (p < 0.05). Thus, SPECT myocardial perfusion imaging with 99mTc MIBI and computer quantitation provides an accurate method for the noninvasive detection of significant coronary artery disease. Furthermore, image quality is generally superior to 201Tl, and reversibly ischemic myocardial segments may be better identified with 99mTc MIBI.

AB - We tested the hypothesis that 99mTc 2-methoxy-isobutyl-isonitrile (99mTc MIBI), a new radiopharmaceutical for myocardial perfusion imaging, provides accurate noninvasive detection of coronary artery disease (CAD). Imaging in patients after exercise and at rest with 99mTc MIBI was compared with imaging after exercise and redistribution with 201Tl in 12 normal subjects and 38 patients with angiographic documentation of CAD (≥ 50% diameter stenosis). We used single-photon emission computed tomography (SPECT) and computer quantitation of regional tracer distribution. The quality of reconstructed images with 99mTc MIBI judged visually was superior to that of 201Tl in 88% of all studies performed and was comparable in the others. With the limits of normal as 2.5 SD below the mean of gender-matched normal volunteers, 201Tl SPECT identified 32 and 99mTc MIBI identified 36 patients with CAD (p = 0.2). 201Tl SPECT identified 45 of 75 (60%) and 99mTc MIBI identified 59 of 75 (79%) stenosed coronary arteries (p < 0.05). The quantitative severity of perfusion defects was similar for the two tracers. 201Tl SPECT identified 104 reversibly ischemic myocardial segments compared with 134 with 99mTc MIBI (p < 0.05). Thus, SPECT myocardial perfusion imaging with 99mTc MIBI and computer quantitation provides an accurate method for the noninvasive detection of significant coronary artery disease. Furthermore, image quality is generally superior to 201Tl, and reversibly ischemic myocardial segments may be better identified with 99mTc MIBI.

UR - http://www.scopus.com/inward/record.url?scp=0024401961&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0024401961&partnerID=8YFLogxK

M3 - Article

C2 - 2785873

AN - SCOPUS:0024401961

VL - 79

SP - 1282

EP - 1293

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 6

ER -