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Myocardial Perfusion Imaging with Thallium-201

Cardiovascular Division, University of Virginia Health Sciences Center, Charlottesville, Virginia

Correspondence: For correspondence or reprints contact: George A. Beller, MD, Cardiovascular Division/Box 158, University of Virginia Heath Sciences Center, Charlottesville, VA 22908.

ABSTRACT

Over the past 15 yr, numerous clinical studies have validated the use of myocardial perfusion imaging with ²⁰¹Tl for detection and evaluation of coronary artery disease (CAD). In addition, ²⁰¹Tl scintigraphy plays a valuable role in the risk stratification of patients with suspected or known CAD to determine prognosis. Typical protocols involve a comparison of stress and rest images to locate regions of myocardial ischemia. Results are comparable from protocols that employ either exercise stress or pharmacologic stress. By combining ²⁰¹Tl scintigraphic criteria with electrocardiographic (ECG) data, the sensitivity for detection of ischemia may be increased by as much as 25%–30%. The introduction of quantitative interpretation and SPECT has increased the accuracy of myocardial perfusion imaging with ²⁰¹Tl. With respect to prognosis, several ²⁰¹Tl scan variables, such as multiple perfusion defects and abnormal ²⁰¹Tl lung uptake, are associated with high risk. Even when cardiac catheterization findings are known, ²⁰¹Tl scintigraphy provides important supplementary information for identifying high-risk subgroups of patients with CAD.

Key Words: myocardial perfusion imaging • thallium-201

FOOTNOTES

This paper was presented in part at the Annual Meeting of the Society of Nuclear Medicine on June 8, 1993, as part of a Continuing Medical Education Semin1ar organized by the Cardiovascular Council.

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