Abstract
To test the clinical significance of technetium-99m teboroxime regional myocardial clearance in the detection of coronary artery disease, 25 patients underwent dynamic planar or single-photon emission tomographic (SPET) myocardial imaging with 99mTc-teboroxime after exercise and again 2 h later at rest. All patients underwent both thallium-201 exercise and redistribution SPET and coronary arteriography. The early phases of exercise 99mTc-teboroxime myocardial clearance determined by dynamic planar imaging showed a significant difference between normal and post-stenotic myocardial regions (clearance rate constant k: 0.047±0.005 min' versus 0.034±0.003 min−1, P <0.001). Reflecting this “differential clearance” between myocardial regions, an early redistribution-like phenomenon was observed in a significant number of myocaridal segments by comparing serially acquired post-exercise 99mTc-teboroxime SPET images. These results indicated that the analysis of 99mTc-teboroxime myocardial clearance was of potential use in the detection of coronary artery disease, yielding additional information to that provided by the tracer distribution analysis. Although the early redistribution-like phenomenon of 99mTc-teboroxime could be the source of underestimation of ischaemia if acquisition of the initial post-exercise image were delayed, it could also prove useful in the early differentiation of ischaemia from scar because when the phenomenon was observed in delayed post-exercise images, the rest study could be omitted under some circumstances.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Narra RK, Nunn AD, Kuczynski BL, Feld T, Wedeking P, Eckelman WC. A neutral technetium-99m complex for myocardial imaging. J Nucl Med 1989;30:1830–1837.
Leppo JA, Meerdink DJ. Comparative myocardial extraction of two technetium-labeled BATO derivatives (SQ3017, SQ32014) and thallium. J Nucl Med 1990;31:67–74.
Seldin DW, Johnson LL, Blood DK, et al. Myocardial perfusion imaging with technetium-99m SQ32017: comparison with thallium-201 and coronary anatomy. J Nucl Med 1989;30:312–319.
Stewart RE, Schwaiger M, Hutchins GD, et al. Myocardial clearance kinetics of tech netium-99m-SQ30217: a marker of regional myocardial blood flow. J Nucl Med 1990;31:1183–1190.
Nakajima K, Taki J, Bunko H, et al. Dynamic acquisition with a three-headed SPELT system: application to technetium 99m-SQ32017 myocardial imaging. J Nucl Med 1991;32:1273–1277.
Li Q-S, Solot G, Frank TL, Wagner FH Jr, Becker JC. Tomographic myocardial perfusion imaging with technetium-99m-teboroxime at rest and after dipyridamole. J Nucl Med 1991;32:1968–1976.
Stewart RE, Heyl B, O'Rourke RA, Blumhardt R, Miller DD. Demonstration of differential post-stenotic myocardial technetium-99m-teboroxime clearance kinetics after experimental ischernia and hyperemic stress. J Nucl Med 1991;32:2000–2008.
Gray WA, Gewirtz H. Comparison of 99mTc-teboroxime with thallium for myocardial imaging in the presence of a coronary artery stenosis. Circulation 1991;84: 1796–1807.
Johnson LL, Seldin DW. Clinical experience with technetium-99m teboroxime, a neutral, lipophilic myocardial perfusion imaging agent. Am J Cardiol 1990;66:63E–67E.
Coleman RE, Maturi M, Nunn AD, et al. Imaging of myocardial perfusion with Tc-99m SQ30217: dog and human studies [abstract]. J Nucl Med 1986;27: 893.
Rumsey WL, Rosenspire KC, Nunn AD. Myocardial extraction of teboroxime: effects of teboroxime interaction with blood. J Nucl Med 1992;33: 94–101.
Johnsoun G III, Glover DK, Hebert CB, Okada RD, Early myocardial clearance kinetics of technetium-99m-teboroxime differentiate normal and flow-restricted canine myocardium at rest. J Nucl Med 1993;34: 630–636.
Taillefer R, Lambert R, Essiambre R, Phaneuf DC, Leveille J. Comparison between thallium-201, technetium-99m-sestamibi and technetium-99m-teboroxime planar myocardial perfusion imaging in detection of coronary artery disease. J Nucl Med 1992;33: 1091–1098.
Goris ML, Daspit SG, McLaughlin P, Kriss JP Interpolative background subtraction. J Nucl Med 1976;17: 744–747.
Hendel RC, McSherry B, Karimeddini M, Leppo JA. Diagnostic value of a new myocardial perfusion agent, teboroxime (SQ30,217), utilitzing a rapid planar imaging protocol: prelimiary results. J Am Coll Cardiol 1990;16: 855–861.
Bok BD, Bice AN, Clausen M, Wong DF, Wagner HN Jr. Artifacts in camera based single photon emission tomography due to time activity variation. Eur J Nucl Med 1987;13: 439–442.
Links JM, Frank TL, Becker L. Effect of differential tracer washout during SPECt acquisition. J Nucl Med 1991;32: 2253–2257.
Stewart RE, Heyl B, Blumhardt R, et al. Differential poststenotic myocardial SQ30217 kinetics following adenosine and dipyridamole-induced hyperemic stress [abstract]. J Nucl Med 1990;31: 735.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Yamagami, H., Ishida, Y., Morozumi, T. et al. Detection of coronary artery disease by dynamic planar and single photon emission tomographic imaging with technetium-99m teboroxime. Eur J Nucl Med 21, 27–36 (1994). https://doi.org/10.1007/BF00182303
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF00182303