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Stress thallium-201/rest technetium-99m sequential dual-isotope high-speed myocardial perfusion imaging validation versus invasive coronary angiography

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Recent advances in nuclear myocardial perfusion imaging (MPI) have made it possible to develop a dual-isotope protocol for high-speed acquisition with image quality and radiation delivery comparable to that obtained with conventional single isotope protocols. So far, no study has compared dual-isotope high-speed MPI to invasive coronary angiography (ICA) in a large cohort using a Cadmium-zinc-telluride SPECT system.

Methods

Over a 1-year period (May 2011 to April 2012), 1366 patients underwent dual-isotope high-speed MPI. Patients with ICA within 3 months after dual-isotope high-speed MPI were included together with patients with a low likelihood of coronary artery disease (CAD) in order to assess normalcy rate. Global summed stress score (SSS) and summed rest score (SRS) were calculated, and ICA results were analyzed independently. The main end point was a patient-based assessment of the diagnostic performance of dual-isotope high-speed MPI in detecting or ruling out significant CAD (>70% reduction in lumen diameter).

Results

Inclusion criteria were fulfilled for 214 patients (143 men; age 60 ± 14 years; ICA, n = 104; low likelihood for CAD, n = 110). An exercise stress test was performed in 62% of patients and a pharmacological stress test was performed with either dipyridamole (32%) or dobutamine (6%). Average examination duration was 22.4 ± 4.5 minutes. Mean SSS, SRS, and SDS were 8.0 ± 4.9, 3.1 ± 4.3, and 5.0 ± 3.2, respectively. Prevalence of angiographic CAD was 75%. ICA detected stenosis in the left main trunk, left anterior descending artery, left circumflex artery, and right coronary artery in 4, 33, 31, and 42 patients, respectively. Sensitivity of dual-isotope high-speed MPI was 94%, normalcy rate was 92%, and accuracy was 83% for detecting CAD.

Conclusion

Dual-isotope high-speed MPI is reliable at detecting or ruling out CAD. NCT01785589

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Conflict of interest

The authors have indicated that they have no financial conflict of interest.

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Authors and Affiliations

  1. Department of Cardiology, CHU Grenoble, University Hospital, BP 217, 38043, Grenoble Cedex 09, France

    Gilles Barone-Rochette MD, PhD, Mélanie Leclere MD, Estelle Vautrin MD, Jean Philippe Baguet MD, PhD, Jacques Machecourt MD & Gérald Vanzetto MD, PhD

  2. INSERM U1039, Bioclinic Radiopharmaceutics Laboratory, Grenoble, France

    Gilles Barone-Rochette MD, PhD, Alexis Broisat PhD, Catherine Ghezzi PhD, Jean Philippe Baguet MD, PhD, Jacques Machecourt MD, Gérald Vanzetto MD, PhD & Daniel Fagret MD, PhD

  3. Department of Nuclear medicine, University Hospital, Grenoble, France

    Alex Calizzano MD, Gallazzini-Crepin Céline MD & Daniel Fagret MD, PhD

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  1. Gilles Barone-Rochette MD, PhD
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  2. Mélanie Leclere MD
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Correspondence to Gilles Barone-Rochette MD, PhD.

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Barone-Rochette, G., Leclere, M., Calizzano, A. et al. Stress thallium-201/rest technetium-99m sequential dual-isotope high-speed myocardial perfusion imaging validation versus invasive coronary angiography. J. Nucl. Cardiol. 22, 513–522 (2015). https://doi.org/10.1007/s12350-014-0016-0

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  • DOI: https://doi.org/10.1007/s12350-014-0016-0

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