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 Google Scholar Google Scholar Articles by Braat, S. H. Articles by Rigo, P. Search for Related Content PubMed PubMed Citation Articles by Braat, S. H. Articles by Rigo, P.

Myocardial Imaging with Technetium-99m-Tetrofosmin: Comparison of One-Day and Two-Day Protocols

Department of Cardiology, Academic Hospital Maastricht, University of Limburg, The NetherLands
Centre Hospitalier Universitaire, Liege, Belgium
Hôpital Neuro-Cardiologique, Lyon, France
Northwick Park Hospital and Clinical Research Centre, Harrow, United Kingdom

Correspondence: For correspondence or reprints contact: Simon H. Braat, Dept. of Cardiology, Academic Hospital Maastricht, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.

ABSTRACT

There is no evidence of myocardial redistribution after tetrofosmin injection, therefore, two separate injections are needed to differentiate scar from ischemia with this tracer. The injections can be given on the same day (one-day protocol) or on separate days (two-day protocol). As part of a Phase II clinical study, a one-day protocol was compared with a two-day protocol. Methods: Fifty-five patients with suspected coronary artery disease were studied according to the following protocol: on the first day at rest, anterior, left lateral, left anterior oblique 40° and 70° images were acquired 30 min after injection of 8 mCi of tetrofosmin for 5 min each. Two days later, exercise and rest images were acquired on the same day. At peak exercise, 8 mCi of tetrofosmin were injected and 30 min later the same four standard planar images were recorded as on Day one. Four hours after the exercise injection, 24 mCi of tetrofosmin were injected at rest and imaging was repeated 30 min later. Qualitative comparisons between the one- and two-day protocols were performed in 50 patients in whom all data were available following blinded evaluation of images by three readers. Results: All three readers reported identical results for the 26 patients. A difference in extent or location between the observers was found in seven patients, differences between normal and abnormal in eight patients, while discrepancies between ischemia and necrosis were noted in four patients. In five patients, an ischemic area was found according to the one-day protocol, but according to the data of the two-day protocol, this area was judged to be necrotic. One observer reported the opposite in one patient. These discrepancies between the reversibility of defects were restricted to the inferior wall. Comparison with ²⁰¹TI data showed no systematic pattern of variation. Conclusion: Tetrofosmin can be used in a one-day protocol. However, in planar imaging, the inferior wall should be reported with caution.

Key Words: tetrofosmin • exercise test • perfusion tracer