Abstract
A confusing multitude of different myocardial perfusion imaging protocols have been proposed during the last few years. The impetus for this development was new insights in imaging with thallium 201 and the challenge to perform efficient imaging with the newly developed technetium 99m-labeled imaging agents. The practicing nuclear cardiologist is confronted with a true maze of options. This review describes in detail the various protocols, discusses advantages and disadvantages of each, and states, when appropriate, the personal preference of the author.
Similar content being viewed by others
References
Pohost GM, Zir LM, Moore RH, McKusick KA, Guiney TE, Beller GA. Differentiation of transiently ischemic from infarcted myocardium by serial imaging after a single dose of thallium-201. Circulation 1977; 55:294–302.
Wackers FJ. Myocardial perfusion imaging In: Gottschalk A, Hoffer PB, Potchen EJ, eds. Golden’s diagnostic radiology. 2nd ed. Diagnostic nuclear medicine. Baltimore: Williams & Wilkins, 1988:291–354.
Cloninger KG, DePuey EG, Garcia EV, et al. Incomplete redistribution in delayed thallium-201 single photon emission computed tomographic (SPECT) images: an overestimation of myocardial scarring. J Am Coll Cardiol 1988;12:955–63.
Kiat H, Berman DS, Maddahi J, et al. Late reversibility of tomographic myocardial thallium-201 defects: an accurate marker of myocardial viability. J Am Coll Cardiol 1988;12:1456–63.
Kayden DS, Sigal S, Soufer R, Mattera J, Zaret BL, Wackers FJ. Thallium-201 for assessment of myocardial viability: quantitative comparison of 24-hour redistribution imaging with imaging after reinjection at rest. J Am Coll Cardiol 1991;18:1480–6.
Dilsizian V, Rocco TP, Freedman NMT, Leon MB, Bonow RO. Enhanced detection of ischemic but viable myocardium by the reinjection of thallium after stress redistribution imaging. N Engl J Med 1990;323:141–6.
van Eck-Smit BLF, van der Wall EE, Kuijper AFM, Zwinderman AH, Pauwels EKJ. Immediate thallium-201 reinjection following stress imaging: a time-saving approach for detection of myocardial viability. J Nucl Med 1993;34:737–43.
Wackers FJ, Pieri PL, McMahon M, et al. Quantitative reproducibility of repeated planar thallium-201 stress imaging [Abstract]. J Nucl Med 1993;34:44P.
He ZX, Darcourt J, Guignier A, et al. Nitrates improve detection of ischemic viable myocardium by thallium-201 reinjection SPECT. J Nucl Med 1993;34:1472–7.
Burns RJ, Galligan L, Wright L. Thallium infusion scintigraphy improves detection of viable myocardium [Abstract]. Circulation 1990;82(suppl):III-554.
Dilsizian V, Perrone-Filardi P, Arrighi JA, et al. Concordance and discordance between stress-redistribution reinjection and rest redistribution thallium imaging for assessing viable myocardium. Comparison with metabolic activity by positron emission tomography. Circulation 1993;88:941–52.
Wackers FJ, Berman DS, Maddahi J, et al. Technetium-99m hexakis 2-methoxyisobutyl isonitrile: human biodistribution, dosimetry, safety, and preliminary comparison to thallium-201 for myocardial perfusion imaging. J Nucl Med 1989;30:301–11.
Kiat H, Maddahi J, Roy LT, et al. Comparison of technetium-99m methoxy isobutyl isonitrile and thallium-201 for evaluation of coronary artery disease by planar and tomographic methods. Am Heart J 1989; 117:1–11.
Taillefer R, Primeau M, Costi P, Lambert R, Leveille J, Latour Y. Technetium-99m-sestamibi myocardial perfusion imaging in detection of coronary artery disease: comparison between initial (1-hour) and delayed (3-hour) postexercise images. J Nucl Med 1991;32:1961–5.
Sinusas AJ, Shi QX, Vitols PH, et al. Impact of regional ventricular function, geometry and dobutamine stress on quantitative Tc-99m-sestamibi defect size. Circulation 1993;881:2224–34.
Taillefer R, Gagnon A, Laflamme L, Gregoire J, Leveille, Phaneuf DC. Same day injections of Tc-99m methoxy isobutyl isonitrile (hexamibi) for myocardial tomographic imaging: comparison between rest-stress and stress-rest injection sequences. Eur J Nucl Med 1989;15:113–7.
Heo J, Kegel J, Iskandrian AS, Cave V, Iskandrian BB. Comparison of same-day protocols using technetium-99m-sestamibi myocardial imaging. J Nucl Med 1992; 33:186–91.
Worsley DF, Fung AY, Coupland DB, Rexworthy CG, Sexsmith GP, Lentle BC. Comparison of stress-only vs. stress/rest with technetium-99m methoxyisobutylisonitrile myocardial perfusion imaging. Eur J Nucl Med 1992;19:441–4.
Jones RH, Borges-Neto S, Potts JM. Simultaneous measurements of myocardial perfusion and ventricular function during exercise from a single injection of technetium-99m-sestamibi in coronary artery disease. Am J Cardiol 1990;66:68E-71E.
Verzijlbergen JF, Suttorp MJ, Ascoop CAPL, et al. Combined assessment of technetium-99m sestamibi planar myocardial perfusion images at rest and during exercise with rest/exercise left ventricular wall motion studies evaluated from gated myocardial perfusion studies. Am Heart J 1992;123:59–68.
DePuey EG, Nichols K, Dobrinsky C. Left ventricular ejection fraction assessed from gated technetium-99m-sestamibi SPECT. J Nucl Med 1993;34:1871–6.
Berman DS, Kiate H, Friedman JD, et al. Separate acquisition rest thallium-201/stress technetium-99m sestamibi dual isotope myocardial perfusion single photon emission computed tomography: a clinical validation study. J Am Coll Cardiol 1993;22:1455–64.
Lowe VJ, Greer KL, Hanson MW, Jaszczak RJ, Coleman RE. Cardiac phantom evaluation of simultaneously acquired dual isotope rest thallium-201/stress technetium-99m-SPECT images. J Nucl Med 1993;34: 1998–2006.
Seldin DW, Johnson LL, Blood DK, et al. Myocardial perfusion imaging with technetium-99m SQ30217: comparison with thallium-201 and coronary anatomy. J Nucl Med 1989;30:312–9.
Hendel RC, McSherry B, Karimeddini M, Leppo JA. Diagnostic value of a new myocardial perfusion agent, teboroxime (SQ 30,217), utilizing a rapid planar imaging protocol: preliminary results. J Am Coll Cardiol 1990;16:855–61.
Chua T, Kiat H, Germano G, et al. Rapid back to back adenosine stress/rest technetium-99m teboroxime myocardial perfusion SPECT using a triple-detector camera. J Nucl Med 1993;34:1485–93.
Jain D, Wackers FJ, Mattera J, McMahon M, Sinusas AJ, Zaret BL. Biokinetics of99mTc-tetrofosmin, a new myocardial perfusion imaging agent: implications for a one day imaging protocol. J Nucl Med 1993;34:1254–9.
Sridhara BS, Braat S, Rigo P, et al. Comparison of myocardial perfusion imaging with technetium-99m-tetrofosmin versus thallium-201 in coronary artery disease. Am J Cardiol 1993;72:1015–9.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Wackers, F.J.T. The maze of myocardial perfusion imaging protocols in 1994. J Nucl Cardiol 1, 180–188 (1994). https://doi.org/10.1007/BF02984090
Issue Date:
DOI: https://doi.org/10.1007/BF02984090