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Dobutamine stress tetrofosmin SPECT; evaluation of short rest-stress protocol and head to head comparison with MIBI in detection of coronary artery disease

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Abstract

Objective

The purpose of the present study was to evaluate the feasibility and diagnostic accuracy of same day short rest-dobutamine stress Tetrofosmin (TF) SPECT imaging protocol and to compare TF SPECT results with MIBI SPECT in the same subjects who were unable to perform treadmill exercise or were unsuitable for pharmacological vasodilator stress.

Methods

The study group consisted of 19 patients (2 female and 17 male, with a mean age of 53.8 ± 7.9 yrs) in whom coronary artery disease (CAD) had been proven or excluded at coronary angiography (CA). MIBI SPECT imaging was performed first. TF SPECT images were obtained one week after MIBI imaging. Immediately after the rest SPECT imaging in both of the MIBI and TF studies, patients underwent dobutamine stress tests. Rest-stress radiotracer doses and dobutamine doses were the same for both TF and MIBI studies. While 60 min waiting periods were applied for MIBI study, only 30 min waiting periods were applied for TF study after the rest and stress injections. Images were evaluated by visual and quantitative analysis.

Results

Dobutamine stress parameters were similar for both studies. Although in TF study, the time between radiopharmaceutical injection and imaging was shorter than in MIBI study, there was no significant difference between heart-to-liver (H/Li) and heart-to-lung (H/Lu) ratios. According to CA results, diagnostic accuracy was similar for TF and MIBI. While sensitivity, specificity and accuracy for TF study were calculated as 82%, 84% and 82%, respectively, the corresponding values for MIBI were 82%, 88% and 84%, respectively. This clinical study has shown comparable diagnostic performance for the detection of CAD between MIBI and TF. Good correlation was found between segmental analysis for both studies.

Conclusion

MIBI and TF showed similar perfusion defects and good segmental correlation during dobutamine stress with the same quality images. Both radiopharmaceuticals may be acceptable with this imaging protocol. Besides this, TF study showed better reversibility degree (55%) in a shorter time when compared to MIBI study (25%) in perfusion defects (especially in segments with severely decreased perfusion or no uptake).

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References

  1. Jain D, Wackers FJ, Mattera J, McMahon M, Sinusas AJ, Zaret BL. Biokinetics of technetium-99m tetrofosmin: myo- cardial imaging agent: implications for a one-day imaging protocol.J Nucl Med 1993; 34: 1254–1259.

    PubMed  CAS  Google Scholar 

  2. Jain D. Technetium-99m labelled myocardial perfusion imaging agents. Cardiovascular nuclear medicine, part 1.Semin Nucl Med 1999; 29: 221–236.

    Article  PubMed  CAS  Google Scholar 

  3. Ravizzini GC, Hanson MW, Shaw LK, Wong TZ, Hagge RJ, Paganelli RA, et al. Efficiency comparison between Tc- 99m tetrofosmin and Tc-99m sestamibi myocardial perfusion studies.Nucl Med Commun 2002; 23: 203–208.

    Article  PubMed  CAS  Google Scholar 

  4. Nakamura K, Sammiya T, Hashimoto J, Ishibashi R, Matsumoto K, Kubo A. Comparison of cationic myocardial perfusion agents: characteristics of accumulation in cultured smooth muscle cells.Ann NuclMed 1996; 10: 375–381.

    Article  CAS  Google Scholar 

  5. Matsunari I, Taki J, Nakajima K, Tonami N, Hisada K. Myocardial viability assessment using nuclear imaging.Ann Nucl Med 2003; 17: 169–179.

    Article  PubMed  CAS  Google Scholar 

  6. Matsunari I, Haas F, Nguyen NTB, Reidel G, Wolf I, Senekowitsch-Schmidtke R, et al. Comparison of sestamibi, tetrofosmin, and Q12 retention in porcine myocardium.J Nucl Med 2001; 42: 818–823.

    PubMed  CAS  Google Scholar 

  7. Schaefer WM, Moka D, Brockmann HA, Schomaecker K, Schicha H. T1-201, Tc-99m MIBI, Tc-99m tetrofosmin and Tc-99m furifosmin: relative retention and clearance kinet- ics in retrogradely perfused guinea pig hearts.Nucl Med Biol 2002; 29: 243–254.

    Article  PubMed  CAS  Google Scholar 

  8. Unlu M, Turgut B, Gunaydin S, Atavci S, Gokgoz L. Dobutamine Tc-99m tetrofosmin SPECT in the detection of coronary artery disease: Evaluation of a same day rest- stress protocol. [Abstract]J NuclMed 1995; 36 (Suppl): 132 P-No. 606.

    Google Scholar 

  9. Hays JT, Mahmarian JJ, Cochran AJ, Verani MS. Dobutamine thallium-201 tomography for evaluating patients with suspected coronary artery disease unable to undergo exercise or vasodilator pharmacologic stress testing.J Am Coll Cardiol 1993; 21: 1583–1590.

    Article  PubMed  CAS  Google Scholar 

  10. Krivokapich J, Huang SC, Schelbert HR. Assessment of the effects of dobutamine on myocardial blood flow and oxida- tive metabolism in normal human subjects using nitrogen- 13 ammonia and carbon-11 acetate.Am J Cardiol 1993; 71: 1351–1356.

    Article  PubMed  CAS  Google Scholar 

  11. Mason JR, Palac RT, Freeman ML, Virupannavar S, Loeb HS, Kaplan E, et al. Thallium scintigraphy during dobutamine infusion: Nonexercise-dependent screening test for coronary disease.Am Heart J 1984; 107: 481–485.

    Article  PubMed  CAS  Google Scholar 

  12. Turgut B, Unlu M, Temiz NH, Kitapci M, Alkan ML. Dobutamine Tc-99m furifosmine SPECT in detection of coronary artery disease: evaluation of same day, rest-stress protocol.Ann Nucl Med 2003; 17: 531–539.

    Article  PubMed  Google Scholar 

  13. Günalp B, Dokumaci B, Uyan C, Vardareli E, Isik E, Bayhan H, et al. Value of dobutamine Technetium-99m sestamibi SPECT and echocardiography in the detection of coronary artery disease compared with coronary angiogra- phy.J Nucl Med 1993; 34: 889–894.

    PubMed  Google Scholar 

  14. Van Train KF, Areeda J, Garcia EV, Cooke CD, Maddahi J, Kiat H, et al. Quantitative same-day rest-stress Techne- tium-99m-sestamibi SPECT: Definition and validation of stress normal limits and criteria for abnormality.J Nucl Med 1993; 34: 1494–1502.

    PubMed  Google Scholar 

  15. Bavelaar-Croon CDL, Wahba FFMF, Van Hecke MV, Atsma DE, Stokkel MPM, Pauwels EKJ, et al. Perfusion and functional abnormalities outside the septal region in patients with left bundle branch block assessed with gated SPECT.Q J Nucl Med 2001; 45: 108–114.

    PubMed  CAS  Google Scholar 

  16. Johansen A, Gaster AL, Veje A, Thayssen P, Haghfelt T, Hoilund-Carlsen PF. Interpretive intra- and interobserver reproducibility of rest/stress Tc-99m sestamibi myocardial perfusion SPECT in a consecutive group of male patients with stable angina pectoris before and after percutaneous transluminal angioplasty.Nucl Med Commun 2001; 22: 531–537.

    Article  PubMed  CAS  Google Scholar 

  17. Rigo P, Benoit T, Foulon J. Myocardial perfusion imaging: Imaging protocols. In:Myocardial perfusion imaging: an update. The Medicine Publishing Foundation Symposium Series, Number 34. Oxford, UK; The Medicine Group (Education) Ltd., 1994: 13–19.

    Google Scholar 

  18. Watson DD. Methods for detection of myocardial viability and ischemia (Chapter 6). Image Display and analysis (Section II).Nuclear Cardiology State of the Art and Future Directions. Zaret BL, Beller GA (eds), St. Louis, Missouri; Mosby-Year Book Inc., 1993: 65–76.

    Google Scholar 

  19. Wackers FJ Th, Berman DS, Maddahi J, Watson DD, Beller GA, Strauss HW, et al. Technetium-99m hexakis 2- methoxyisobutyl isonitrile: human biodistribution, dosim- etry, safety, and preliminary comparison to thallium-201 myocardial perfusion imaging.J Nucl Med 1989; 30: 301- 311.

    PubMed  CAS  Google Scholar 

  20. Higley B, Smith FW, Smith T, Gemmel HG, Gupta PD, Gvozdanovic DV, et al. Technetium-99m l,2-bis[bis(2- ethoxyethyl)phosphino]ethane: Human biodistribution, dosimetry and safety of a new myocardial perfusion imaging agent.J Nucl Med 1993; 34: 30–38.

    PubMed  CAS  Google Scholar 

  21. Arbab AS, Koizumi K, Toyama K, Arai T, Araki T. Tech- netium-99m-tetrofosmin, technetium-99m-MIBI and thallium-201 uptake in rat myocardial cells.J Nucl Med 1998; 39: 266–271.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Nuclear Medicine, Cumhuriyet University School of Medicine, P.K. 848, 58140, Sivas, Turkey

    Bulent Turgut

  2. Department of Nuclear Medicine, Gazi University School of Medicine, Ankara, Turkey

    Mustafa Unlu

  3. Department of Cardiology, Gazi University School of Medicine, Ankara, Turkey

    Atiye Cengel

Authors
  1. Bulent Turgut
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  2. Mustafa Unlu
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  3. Atiye Cengel
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Correspondence to Bulent Turgut.

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Turgut, B., Unlu, M. & Cengel, A. Dobutamine stress tetrofosmin SPECT; evaluation of short rest-stress protocol and head to head comparison with MIBI in detection of coronary artery disease. Ann Nucl Med 19, 115–122 (2005). https://doi.org/10.1007/BF03027390

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  • DOI: https://doi.org/10.1007/BF03027390

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