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The Canadian exercise technetium 99m-labeled teboroxime single-photon emission computed tomographic study

  • Original Articles
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

99mTc-labeled teboroxime undergoes rapid washout from the myocardium. For this reason, its use has been favored in conjunction with pharmacologic stress, which enables patient positioning before tracer administration, and multidetector single-photon emission computed tomography (SPECT), which enables rapid acquisition. We evaluated treadmill exercise 99mTc-labeled teboroxime SPECT with single-detector systems for the detection of coronary artery disease.

Methods and Results

Treadmill exercise 99mTc-labeled teboroxime SPECT was compared with analogous 201TI-labeled imaging in 108 patients. Teboroxime was injected first during exercise and then at rest. Nine myocardial segments per study were scored with respect to uptake of activity during stress and at rest (teboroxime) or after redistribution (201TI). Perfusion was defined as normal, reversible, or fixed. Overall agreement of 201TI versus teboroxime segmental perfusion (normal vs abnormal) was 772/961 (80.3%; \gc2 = 258; p<0.001; κ=0.51) or (normal vs reversible vs fixed) 711/961 (74.0%; \gc2 = 296; p<0.001; κ=0.42). Fifty-six patients also underwent selective coronary angiography. Stenoses greater than 50% of lumenal diameter were drawn on individualized coronary artery diagrams applied to polar plots of scintigraphic segments to compare detection of coronary artery disease. Sensitivity and accuracy of teboroxime were 0.80 and 0.79, respectively, compared with 0.84 and 0.82 for 201TI (difference not significant). Mean imaging procedure time was 113.6 minutes for teboroxime and 240.5 minutes for 201TI (p<0.001).

Conclusions

99mTc-labeled teboroxime is amenable to simple modifications of routine treadmill exercise SPECT myocardial perfusion imaging protocols with widely available single-detector SPECT systems. This modality provides results similar to those of exercise 201TI SPECT and is significantly faster.

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Authors and Affiliations

  1. Nuclear Cardiology Laboratory, Division of Cardiology, Department of Medicine, The Toronto Hospital, 399 Bathurst St., M5T 2S8, Toronto, Ontario, Canada

    Robert J. Burns, Sian Iles, Anthony Y. Fung, Linda M. Wright & Luc Daigneault

  2. Centre for Cardiovascular Research, University of Toronto, Toronto, Ontario

    Robert J. Burns, Sian Iles, Anthony Y. Fung, Linda M. Wright & Luc Daigneault

  3. Department of Nuclear Medicine, Victoria General Hospital, Halifax, Nova Scotia

    Robert J. Burns, Sian Iles, Anthony Y. Fung, Linda M. Wright & Luc Daigneault

  4. Division of Cardiology, Department of Medicine, Vancouver General Hospital, Vancouver, British Columbia

    Robert J. Burns, Sian Iles, Anthony Y. Fung, Linda M. Wright & Luc Daigneault

  5. Bristol-Myers Squibb Pharmaceutical Group, Montreal, Quebec

    Robert J. Burns, Sian Iles, Anthony Y. Fung, Linda M. Wright & Luc Daigneault

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  1. Robert J. Burns
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  2. Sian Iles
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  4. Linda M. Wright
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  5. Luc Daigneault
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the Canadian Exercise Teboroxime SPECT Study Investigators

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Supported by a grant from Squibb Diagnostics Canada.

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Burns, R.J., Iles, S., Fung, A.Y. et al. The Canadian exercise technetium 99m-labeled teboroxime single-photon emission computed tomographic study. J Nucl Cardiol 2, 117–125 (1995). https://doi.org/10.1016/S1071-3581(95)80022-0

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  • DOI: https://doi.org/10.1016/S1071-3581(95)80022-0

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