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Comparison Between Thallium-201, Technetium-99m-Sestamibi and Technetium-99m-Teboroxime Planar Myocardial Perfusion Imaging in Detection of Coronary Artery Disease

From the Department of Nuclear Medicine and Division of Cardiology, Hôpital Hôtel-Dieu de Montréal, Université de Montréal, Montréal, Canada

Correspondence: For reprints contact: Dr. Raymond Taillefer, Département de Médecine Nucléaire, Hôtel-Dieu de Montréal, 3840 St-Urbain St., Montreal, Quebec, H2W 1T8, Canada.

ABSTRACT

Technetium-99m-sestamibi (MIBI) and ^99mTc-teboroxime (TEBO) are two new myocardial perfusion imaging agents. The purpose of this prospective study was to compare MIBI and TEBO to ²⁰¹Tl planar imaging. Eighteen patients with significant coronary artery disease on coronary angiogram were submitted to three treadmill stress tests performed within 3 mo and were imaged with the three radiopharmaceuticals as follows.

1 Tl: 2.2 mCi, immediate and delayed views (4 hr later, 8 min/view).

2 TEBO: 15–20 mCi at stress (1 min/view) and a second injection was repeated 4 hr later at rest (20–25 mCi).

3 MIBI: 15–18 mCi at stress (8 min/view) and 1–4 days later, 15–18 mCi at rest.

Patients achieved similar levels of exercise. A blinded reading was performed by three observers. The left ventricle was divided into three segments/view and ischemic/normal wall ratios were also determined. Segmental comparison showed an agreement in 85% (138/162) of the segments between Tl and TEBO, in 92% (149/162) between Tl and MIBI and in 84% (136/162) between MIBI and TEBO. Abnormal Tl, MIBI and TEBO studies were seen in 16 (89%), 16 (89%) and 15 (83%) patients, respectively, detecting 77, 75 and 65 abnormal segments. Ischemic-to-normal wall ratios were 0.75 ± 0.06, 0.73 ± 0.08 and 0.78 ± 0.08 for Tl, MIBI and TEBO, respectively. In conclusion, although the biologic characteristics of these agents are different, this study showed a good correlation between them in detection of significant coronary artery disease (high pretest likelihood population).

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