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Significance of Fill-In After Thallium-201 Reinjection Following Delayed Imaging: Comparison with Regional Wall Motion and Angiographic Findings

Department of Radiology and Nuclear Medicine, The Third Division, Department of Internal Medicine, and Department of Cardiovascular Surgery, Kyoto University Faculty of Medicine, Kyoto, Japan

Correspondence: For reprints contact: Nagara Tamaki, MD, Department of Radiology and Nuclear Medicine, Kyoto University Hospital, Shogoin, Sakyo-ku, Kyoto, 606 Japan.

ABSTRACT

To identify reversible defects, reinjection of a small amount of thallium-201 (²⁰¹Tl) following 3-hr delayed imaging was performed in 60 patients with coronary artery disease who had perfusion abnormalities on their post-exercise ²⁰¹Tl images. Thallium-201 uptake was visually scored and judged as normal (Group I), reversible defect (Group II), new fill-in after reinjection (Group IIIa) and no fill-in even after reinjection (Group IIIb). New fill-in after reinjection was observed in 27 segments of the 85 segments (32%), showing persistent defect on the stress and delayed images. The wall motion in Group IIIa was worse than Group II but better than Group IIIb. Group IIIa showed Q-wave on ECG more often (69%) than Group II (27%) (p < 0.01), but less often than Group IIIb (85%)(p < 0.05). These data indicate that the reinjection ²⁰¹Tl imaging often identifies new fill-in in the areas of no redistribution on the delayed images and it may hold promise for assessing tissue viability which the conventional imaging may underestimate.

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