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Seven-Pinhole Emission Tomography with Thallium-201 in Patients with Prior Myocardial Infarction

University of Washington and Veterans Administration Medical Center, Seattle, Washington
Veterans Administration Medical Center, Ann Arbor, Michigan

Correspondence: For reprints contact: J. L. Ritchie, MD, Seattle VA Medical Center, Div. of Cardiology, 4435 Beacon Ave. South, Seattle, WA 98108.

ABSTRACT

Thirty-six patients with prior myocardial infarction, and 14 patients without, had myocardial Imaging at rest using both seven-pinhole emission tomography and planar Imaging with thallium-201. The sensitivity and specificity of the two approaches for the detection of prior myocardial infarction were compared. Qualitatively, planar imaging yielded sensitivities of 69% (25 of 36) and 80% (29 of 36) with Polaroid and video display formats,respectively. A semiquantitative analysis gave a sensitivity of 75% (27 of 36). Specificities for these three planar approaches were, respectively, 100% (14 of 14), 93% (13 of 14), and 71% (10 of 14) for the Polaroid, video, and semiquantitative analyses.

Seven-pinhole tomography had a sensitivity of 83% (30 of 36) by qualitative or visual inspection and 86% (31 of 36) by semiquantitative analysis. Specificities by these two techniques were 71% (10 of 14) and 57% (8 of 14). There were no statistically significant differences in either sensitivity or specificity between the planar and tomographic approaches. Repeat seven-pinhole images were identical in 95% (46 of 48) of patients, showing that reproducibility was satisfactory. We conclude that the seven-pinhole tomographic approach has no advantage over standard planar imaging in the detection of prior myocardial infarction.