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Clinical Comparison of Technetium-99m-Teboroxime and Thallium-201 Utilizing a Continuous SPECT Imaging Protocol

Department of Radiology, Division of Nuclear Medicine, University of Miami School of Medicine, and Cedars Medical Center, Miami, Florida

Correspondence: For reprints contact: Aldo N. Serafini, MD, University of Miami School of Medicine D-57, 1611 N.W. 12 St., Miami, FL 33136.

ABSTRACT

To examine the advantages of a ^99mTc-labeled cardiac perfusion agent, teboroxime or SQ30,217 (Squibb Diagnostics), a prospective study was undertaken comparing it to ²⁰¹ Tl stress testing in 17 patients suspected or known of having coronary artery disease (CAD). All patients were studied utilizing a single-detector SPECT camera with a continuous acquisition imaging protocol. Testing was performed on a treadmill to comparable levels with both agents within a 2-wk period. Concordance between the two studies on a patient by patient basis was seen in 16/17 (94%) patients, and discordance was seen in 1/17 (6%) patients. Comparison of findings between ²⁰¹TI and ^99mTc-teboroxime on a segment by segment basis showed concordance in 107/119 (90%) segments, and 12/119 (10%) were discordant. Both examinations independently detected an equal number of normal (77) and abnormal (42) segments. There was no significant difference between the two agents in classifying lesions as ischemic, although there were significant differences between thallium and teboroxime in classifying infarct and infarct/ischemia. Technetium-99m-teboroxime SPECT imaging is a clinically useful method for detecting CAD, with a major advantage being the shorter examination time per individual patient study. The mean total examination time for completion of the ^99mTc-teboroxime study was 2.5 hr versus 4.0 hr for ²⁰¹Tl.