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Comparison of Technetium-99m-Q3 and Thallium-201 for Detection of Coronary Artery Disease in Humans

From the Division of Cardiology, Department of Internal Medicine
E. L. Saenger Radioisotope Laboratory
Departments of Radiology and Chemistry, University of Cincinnati, Cincinnati, Ohio
Mallinckrodt Medical Inc., St. Louis, Missouri

Correspondence: For correspondence or reprints contact: Myron C. Gerson, MD, University of Cincinnati, Division of Cardiology, Mail Location #542, Cincinnati, OH 45267-0542.

ABSTRACT

Technetium-99m-Q3 is a myocardial imaging agent that produces prompt myocardial visualization in humans. Methods: In 19 patients with angiographic coronary artery disease, 2 patients with no angiographic coronary artery stenosis greater than 50% of the luminal diameter and 6 healthy volunteers, exercise and resting myocardial imaging were performed with ^99mTc-Q3 and also with ²⁰¹Tl. Technetium-99m-Q3 imaging began 15 min after injection at rest and with exercise, in a complete imaging sequence that required less than 100 min. Results: Overall accuracy for coronary disease detection was 78% (21 true-positive or true-negative studies among 27 study participants) by tomographic thallium imaging versus 89% for ^99mTc-Q3 tomographic imaging (p = ns). Accuracy for detection of individual coronary stenoses was 75% (61 true-positive or true-negative coronary segment classifications among 81 total coronary segments) for ²⁰¹Tl imaging and 83% for ^99mTc-Q3 imaging (p = ns). Conclusions: Technetium-99m-Q3 when used in a rest-exercise sequence that can be completed in 100 min appears to provide comparable diagnostic accuracy to ²⁰¹Tl for overall coronary disease detection and detection of individual coronary artery stenoses.

Key Words: myocardial perfusion imaging • technetium-99m-Q3