European Journal of Nuclear Medicine

, Volume 28, Issue 7, pp 907–910

Comparison of 99mTc-sestamibi lung/heart ratio, transient ischaemic dilation and perfusion defect size for the identification of severe and extensive coronary artery disease

  • Michel Romanens
  • Christoph Grädel
  • Hugo Saner
  • Matthias Pfisterer
Short Communication

DOI: 10.1007/s002590100532

Cite this article as:
Romanens, M., Grädel, C., Saner, H. et al. Eur J Nucl Med (2001) 28: 907. doi:10.1007/s002590100532

Abstract.

The ability to identify patients with severe coronary artery disease (CAD) by analysis of perfusion defects is limited. The lung/heart ratio (LHR) and transient ischaemic dilatation (TID) have been used for this purpose in thallium-201 scintigraphy. The value of these parameters in technetium-99m sestamibi single-photon emission tomography (SPET) imaging is controversial. In this study, therefore, we determined TID and LHR in a single-day rest/stress 99mTc-sestamibi SPET perfusion protocol and compared these measurements with perfusion defect size (PDS) and angiographic severity of CAD. Severe CAD was defined as >75% left main coronary stenosis and/or >90% proximal left anterior descending artery stenosis and/or >90% proximal stenosis in the left circumflex and right coronary arteries. LHR was determined from a stress anterior planar image recorded ≤6 min after exercise. TID ratio was derived from automatically calculated left ventricular rest/stress volumes, and PDS was measured based on semi-automated computer software (CEqual). Diagnostic accuracy and predictive values were compared between 22 patients with severe and 98 patients without severe CAD. LHRs showed a higher sensitivity (73%) for the assessment of severe CAD as compared to PDS and TID ratio (41% and 23% respectively, P<0.01), whereas specificity was highest for TID ratio [95%, P<0.01 when compared to PDS (84%) and LHR (82%)]. It is concluded that increased LHR in 99mTc-sestamibi myocardial perfusion imaging seems to yield good diagnostic accuracy in the detection of patients with severe CAD and may be derived from a single-day rest/stress study.

Severe coronary artery disease Scintigraphy Lung/heart ratio Transient ischaemic dilation ratio 

Copyright information

© Springer-Verlag 2001

Authors and Affiliations

  • Michel Romanens
    • 1
  • Christoph Grädel
    • 2
  • Hugo Saner
    • 3
  • Matthias Pfisterer
    • 2
  1. 1.The Institute of Radiology, Rodiag Group, Olten, SwitzerlandSwitzerland
  2. 2.Division of Cardiology, University Hospital Kantonspital, 4031 Basel, SwitzerlandSwitzerland
  3. 3.The Cantonal Hospital of Olten, SwitzerlandSwitzerland

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