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Left Ventricular Perfusion and Performance from a Single Radiopharmaceutical and One Camera

Departments of Medicine and Radiology, Columbia University, New York, New York

Correspondence: For reprints contact: Lynne L. Johnson, MD, Dept. of Medicine, Columbia University, 630 west 168th St., New York, NY 10032.

ABSTRACT

To test the hypothesis that a small field of view portable multicrystal scintillation camera can perform stress/rest combined LV function by first-pass and perfusion studies using ^99mTc-teboroxime, 26 patients with positive stress thallium studies within 2 wk and 8 healthy volunteers were studied. A ²⁴¹Am point source marker over the sternum was used for motion correction. Dynamic dual-isotope (^99mTc/²⁴¹Am) acquisition was performed following injection of 15.6 ± 2.3 mCi of ^99mTc-teboroxime at peak treadmill exercise. Two minutes later (blood-pool clearance), while still standing on the flat treadmill, 3–4 40-sec planar images were acquired. One hour later patients were reinjected with 22.7 ± 3.4 mCi of ^99mTc-teboroxime while standing in front of the camera and the same dynamic/static acquisition protocol repeated. The planar images were interpolated from a 20 x 20 matrix to a 160 x 160 matrix, a sharpening filter and an interpolative background subtraction algorithm applied. The scans were divided into segments, each scored as normal, reversible and fixed. The agreement with thallium imaging for identifying an abnormal scan was 24/26 (92%) and for identifying abnormal vascular territories was 43/52, (83%). Fourteen patients had exercise LVEF <50% and all had either prior myocardial infarction, myocardial infarction plus ischemia or LAD ischemia. Diagnostic planar perfusion images and exercise LVEF can be acquired in less than 4 min using ^99mTc-teboroxime and a portable multicrystal scintillation camera.

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