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Myocardial technetium 99m-labeled teboroxime clearance derived from canine scans differentiates severity of stenosis after dipyridamole

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Abstract

Background

The purposes of this study were to determine (1) whether perfusion defects and differential teboroxime clearance observed on serial postdipyridamole planar gamma camera images have utility in differentiating severity of coronary stenosis in canine myocardium and (2) whether single-zone (99mTc activity in one zone over time) or dual-zone (99mTc activity ratio in two zones over time) quantitative analysis provides the most useful characterization of teboroxime clearance kinetics.

Methods and Results

Accordingly, eight dogs received a mild coronary stenosis (microsphere-determined, post-dipyridamole flow ≥0.4 ml/min/gm) and 10 dogs received a severe coronary stenosis (flow ≤0.3 ml/min/gm). In three control dogs there was no coronary stenosis. Teboroxime (5 mCi) was injected after dipyridamole (0.8 mg/kg/min), and gamma camera imaging was begun immediately and continued for 60 minutes. Quantitative analysis of single-zone clearance curves indicated that teboroxime retention for both zones of stenosis (mild=66.3%±2.8%, SEM; severe=69.5%±3.7%) was significantly greater than control zone retention (54.5%±3.0%;p<0.05) at 10 minutes. Retention in mild (37.2%±1.9%, SEM) and severe (42.3%±1.5%) zones of stenosis was significantly different from each other at 60 minutes (p<0.05). There was a significant direct, linear correlation of flow with teboroxime clearance at 20 minutes (r=+0.74, normal and ischemic zones). Quantitative analysis with dual-zone count ratios (stenosed/normal) demonstrated significant differences among control (0.93±0.04, SEM), mild stenoses (0.54±0.04), and severe stenoses (0.39±0.03) as early as 2 minutes after administration of99mTc-labeled teboroxime. The correlation coefficient for flow ratio versus dual-zone counts/pixel ratio at 20 minutes wasr=+0.74.

Conclusion

Thus in this canine stenosis model with dipyridamole, gamma camera imaging could distinguish mild from severe coronary stenoses by either single- or dual-zone analysis.

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References

  1. 1.

    Narra RK, Feld T, Wedeking P, Maytas J, Nunn AD, Coleman RE. SQ30217, a technetium-99m labeled myocardial imaging agent which shows no interspecies differences in uptake. Nuklearmedizin 1987;23(suppl):489–91.

  2. 2.

    Leppo JA, Meerdink DJ. Comparative extraction of two technetium-labeled BATO derivatives (SQ30217, SQ32014) and thallium. J Nucl Med 1990;31:67–74.

  3. 3.

    Glover DK, Okada RD, Hebert CB. Tc-99m-teboroxime (SQ30217, CardioTec) kinetics in normal and ischemic canine myocardium [Abstract]. Circulation 1990;4(suppl):486.

  4. 4.

    Stewart RE, Schwaiger M, Hutchins GD, et al. Myocardial clearance kinetics of technetium-99m-SQ30217: a marker of regional myocardial blood flow. J Nucl Med 1990;31:1183–90.

  5. 5.

    Johnson G III, Glover DK, Hebert CB, Okada RD. Early myocardium clearance kinetics of technetium-99m-teboroxime differentiate normal and flow-restricted canine myocardium at rest. J Nucl Med 1993;34:630–6.

  6. 6.

    Stewart RE, Heyl B, O’Rourke RA, Blumhardt R, Miller DD. Demonstration of differential post-stenotic myocardial technetium-99m-teboroxime clearance kinetics after experimental ischemia and hyperemia stress. J Nucl Med 1991;32:2000–8.

  7. 7.

    Gray WA, Gewirtz H. Comparison of99mTc-teboroxime with thallium for myocardial imaging in the presence of a coronary artery stenosis. Circulation 1991;84:1796–807.

  8. 8.

    Johnson G III, Okada RD, Hebert CB. Myocardial kinetics of technetium-99m teboroxime in a canine stenosis model following dipyridamole [Abstract]. J Nucl Med 1991;32:948.

  9. 9.

    Hendel RC, McSherry M, Karimeddini M, Leppo JA. Diagnostic value of a new myocardial perfusion agent, teboroxime (SQ30217), utilizing a rapid planar imaging protocol: preliminary results. J Am Coll Cardiol 1990;16:855–61.

  10. 10.

    Weinstein H, Dahlberg ST, McSherry BA, Hendel RC, Leppo JA. Rapid redistribution of teboroxime. Am J Cardiol 1993;71:848–52.

  11. 11.

    Chua T, Kiat H, Germano G, et al. Technetium-99m teboroxime regional myocardial washout in subjects with and without coronary artery disease. Am J Cardiol 1993;72:728–34.

  12. 12.

    Squibb (CardioTec) package insert, Squibb Diagnostics, Princeton, New Jersey.

  13. 13.

    Domenech RJ, Hoffman JIE, Noble MIM, Saunders KS, Henson JR, Subijanto S. Total and regional coronary blood flow measured by radioactive microspheres in conscious and anesthetized dogs. Circ Res 1969;25:581–96.

  14. 14.

    Fleming RM, Kirkeide RL, Taegtmeyer H, Adyanthaya A, Cassidy DB, Goldstein RA. Comparison of technetium 99-teboroxime tomography with automated quantitative coronary arteriography and thallium-201 tomographic imagery. J Am Coll Cardiol 1991;17:1297–302.

  15. 15.

    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.

  16. 16.

    Li Q-S, Solot G, Frank TL, Wagner HN Jr, Becker LC. Tomographic myocardial perfusion imaging with technetium-99m-teboroxime at rest and after dipyridamole. J Nucl Med 1991;32:1968–76.

  17. 17.

    Drane WE, Deim S, Strickland P, Tineo A, Nicole M. Preliminary report of SPECT imaging with Tc-99m teboroxime in ischemic heart disease. Clin Nucl Med 1992;17:215–25.

  18. 18.

    Bontemps L, Geronicola-Trapali X, Sayegh Y, Delmas O, Itti R, Andre-Fouet X. Technetium-99m teboroxime scintigraphy. Eur J Nucl Med 1991;18:732–9.

  19. 19.

    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;33:1091–8.

  20. 20.

    Serafini AN, Topchik S, Jimenez H, Friden A, Ganz WI, Sfakianakis GN. Clinical comparison of technetium-99m-teboroxime and thallium-201 utilizing a continuous SPECT imaging protocol. J Nucl Med 1992;33:1304–11.

  21. 21.

    Dahlberg ST, Weinstein H, Hendel RC, McSherry B, Leppo JA. Planar myocardial perfusion imaging with technetium-99m-teboroxime: comparison by vascular territory with thallium-201 and coronary angiography. J Nucl Med 1992;33:1783–8.

  22. 22.

    Labonte C, Taillefer R, Lambert R, et al. Comparison between technetium-99m-teboroxime and thallium-201 dipyridamole planar myocardial perfusion imaging in detection of coronary artery disease. Am J Cardiol 1991;69:90–6.

  23. 23.

    Iskandrian AS, Heo J, Nguyen T, et al. Tomographic myocardial perfusion imaging with technetium-99m teboroxime during adenosine-induced coronary hyperemia: correlation with thallium-201 imaging. J Am Coll Cardiol 1992;19:307–12.

  24. 24.

    Marshall RC, Leidholdt EM Jr, Zhang D-Y, Barnett CA. The effect of flow on technetium-99m-teboroxime (SQ30217) and thallium-201 extraction and retention in rabbit heart. J Nucl Med 1991;32:1979–88.

  25. 25.

    Beanlands R, Muzik O, Nguyen N, Petry N, Schwaiger M. The relationship between myocardial retention of technetium-99m teboroxime and myocardial blood flow. J Am Coll Cardiol 1992;20:712–21.

  26. 26.

    Dahlberg ST, Gilmore MP, Siwko R, Leppo JA. Incubation with red blood cells reduces the extraction of technetium-99m teboroxime in the isolated rabbit heart [Abstract]. J Nucl Med 1991;32:910.

  27. 27.

    Rumsey WL, Rosenspire KC, Nunn AD. Myocardial extraction of teboroxime: effects of teboroxime interaction with blood. J Nucl Med 1992;33:94–101.

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Correspondence to Gerald Johnson.

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Johnson, G., Glover, D.K., Hebert, C.B. et al. Myocardial technetium 99m-labeled teboroxime clearance derived from canine scans differentiates severity of stenosis after dipyridamole. J Nucl Cardiol 1, 338–350 (1994). https://doi.org/10.1007/BF02939955

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Key Words

  • teboroxime
  • scans
  • stenosis
  • dipyridamole