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Thallium-201 Scintigraphic Quantitation of Regional Flow Disparity and Subsequent Redistribution in Dogs

Division of Cardiology and Departments of Medicine and Nuclear Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York

Correspondence: For reprints contact: Richard M. Steingart, MD, Div. of Cardiology, Montefiore Medical Center, 111 East 210th St., Bronx, NY 10467.

ABSTRACT

Although quantitative analysis of postexercise thallium-201 (²⁰¹Tl) scintigrams has been employed clinically for the diagnosis of coronary disease, the precise relationship of the quantitated defects to microsphere determined blood flow has not been determined. Accordingly, ²⁰¹Tl was injected during exercise in 12 control dogs and seven with left circumflex (LCf) artery stenosis. Gamma camera scanning was started 10 min after ²⁰¹Tl injection and continued for 3 hr. In the control animals, scintigraphic ²⁰¹Tl activities in left anterior descending (LAD) and LCf perfusion territories were equal 10 min after ²⁰¹Tl injection and the loss of ²⁰¹Tl activity over 3 hr was 54.3 ± 3.4% and 57.0 ± 3.6% (mean ± s.e.e.) of initial LAD and LCf activity, respectively (p = N.S.). In the experimental group, LCf activity 10–14 min after ²⁰¹Tl injection averaged 67.4 ± 5.9% of LAD activity in the same heart (p <0.001). Furthermore, LCf activity in the experimental animals was significantly lower than LCf activity in the control dogs (p <0.005), while LAD activities were not different in the two groups. The ratio of LCf/LAD scintigraphic ²⁰¹Tl activity immediately after exercise was linearly related to, but higher than, the ratio of regional blood flows at peak exercise (r = 0.88, p <0.001) as determined by microsphere injection. Scintigraphic redistribution was also correlated with directly measured redistribution determined by well counter analysis (r = 0.83, p <0.025). Thus, in this exercise model, quantitative ²⁰¹Tl scintigraphy accurately assessed the initial postexercise flow disparity and subsequent redistribution.

FOOTNOTES

* Presented in part at the National Meeting of the American Federation for Clinical Research, Washington, DC, May 2, 1983.