HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Villanueva-Meyer, J. Articles by Narahara, K. A. Search for Related Content PubMed PubMed Citation Articles by Villanueva-Meyer, J. Articles by Narahara, K. A.

Assessment of Myocardial Perfusion Defect Size After Early and Delayed SPECT Imaging with Technetium-99m-Hexakis 2-Methoxyisobutyl Isonitrile After Stress

Departments of Radiology and Medicine, UCLA School of Medicine, Los Angeles, California
Divisions of Nuclear Medicine and Cardiology, Los Angeles County Harbor-UCLA Medical Center, Torrance, California

Correspondence: For correspondence or reprints contact: Kenneth A. Narahara, MD Cardiology Division, Harbor-UCLA Medical Center 1000 W. Carson St., Torrance, CA 90509.

ABSTRACT

It is thought that the distribution of ^99mTc-sestamibi undergoes minimal change during the first 4 hr after injection. Thus [^99mTc] sestamibi unlike ²⁰¹Tl should not demonstrate significant redistribution in ischemic myocardium. We tested this assumption by quantifying perfusion defect size in early and delayed clinical SPECT images obtained after exercise stress or after dipyridamole infusion using an automated algorithm. Twenty patients with coronary artery disease aged 55 ± 10 yr (13 male and 7 female) underwent stress imaging. Technetium-99m-sestamibi was injected at peak exercise stress in 12 patients and after an intravenous infusion of dipyridamole in 8 patients; SPECT images were obtained 1 and 4 hr later. All patients underwent rest imaging with a second dose of ^99mTc-sestamibi 1–3 days after the stress studies. Total left ventricular mass and left ventricular defect mass were quantified with an automated algorithm previously validated in animal and patient studies. Estimates of total left ventricular mass from studies obtained 1 hr after stress (341 ± 90 g) were comparable to values obtained after 4 hr (336 ± 89 g), with a correlation of r = 0.97; p < 0.0001. The left ventricular defect size 1 hr after exercise or dipyridamole infusion (149 ± 74 9) was similar to that observed after 4 hr (151 ± 73 g). The two measurements of hypoperfusion with stress were highly correlated (r = 0.91; p < 0.0001) and were significantly larger than the defect size at rest (121 ± 70 g). These observations support the conclusion that ^99mTc-sestamibi does not redistribute significantly in ischemic myocardium between 1 and 4 hr after injection.

FOOTNOTES

^* Current address: Division of Nuclear Medicine, University of Texas Medical Branch, Galveston, TX.

This article has been cited by other articles:

				J. D. Bremner, N. Fani, A. Ashraf, J. R. Votaw, M. E. Brummer, T. Cummins, V. Vaccarino, M. M. Goodman, L. Reed, S. Siddiq, et al. Functional Brain Imaging Alterations in Acne Patients Treated With Isotretinoin Am J Psychiatry, May 1, 2005; 162(5): 983 - 991. [Abstract] [Full Text] [PDF]

				J. D. Bremner, M. Vythilingam, C. K. Ng, E. Vermetten, A. Nazeer, D. A. Oren, R. M. Berman, and D. S. Charney Regional Brain Metabolic Correlates of {alpha}-Methylparatyrosine-Induced Depressive Symptoms: Implications for the Neural Circuitry of Depression JAMA, June 18, 2003; 289(23): 3125 - 3134. [Abstract] [Full Text] [PDF]

				J. Taki, S. Fujino, K. Nakajima, I. Matsunari, H. Okazaki, T. Saga, H. Bunko, and N. Tonami 99mTc-Sestamibi Retention Characteristics During Pharmacologic Hyperemia in Human Myocardium: Comparison with Coronary Flow Reserve Measured by Doppler Flowire J. Nucl. Med., October 1, 2001; 42(10): 1457 - 1463. [Abstract] [Full Text] [PDF]

				D. M. Shavelle, M. J. Budoff, D. H. LaMont, R. M. Shavelle, J. M. Kennedy, and B. H. Brundage Exercise testing and electron beam computed tomography in the evaluation of coronary artery disease J. Am. Coll. Cardiol., July 1, 2000; 36(1): 32 - 38. [Abstract] [Full Text] [PDF]

				V. Sansoy, D. K. Glover, D. D. Watson, M. Ruiz, W. H. Smith, J. P. Simanis, and G. A. Beller Comparison of Thallium-201 Resting Redistribution With Technetium-99m–Sestamibi Uptake and Functional Response to Dobutamine for Assessment of Myocardial Viability Circulation, August 15, 1995; 92(4): 994 - 1004. [Abstract] [Full Text]