- 作者：Daniel S. Berman ; MD?/sup> ; &dagger ; ; bermand@cshs.org ; Xingping Kang ; MD?/sup> ; Balaji Tamarappoo ; MD?/sup> ; Arik Wolak ; MD?/sup> ; Sean W. Hayes ; MD?/sup> ; &dagger ; ; Ryo Nakazato ; MD?/sup> ; Louise E.J. Thomson ; MBChB ; MSc?/sup> ; Faith Kite ; BS?/sup> ; Ishac Cohen ; PhD?/sup> ; Piotr J. Slomka ; PhD?/sup> ; &dagger ; ; Andrew J. Einstein ; MD ; PhD&Dagger ; ; John D. Friedman ; MD?/sup> ; &dagger ;
- 关键词：dual isotope imaging ; high-speed SPECT ; myocardial perfusion imaging ; coronary artery disease
- 刊名：JACC: Cardiovascular Imaging
- 出版年：2009
- 出版时间：March 2009
- 年：2009
- 卷：2
- 期：3
- 页码：273-282
- 全文大小：657 K
Objectives
Our purpose was to describe a novel, rapid stress thallium-201 (Tl-201)/rest technetium-99m (Tc-99m) agent myocardial perfusion imaging (MPI) protocol (Tl/Tc) with a high-speed MPI scanner and to compare this protocol with a standard rest/stress Tc-99m agent protocol (Tc/Tc) with respect to image quality and radiation dosimetry.Background
Recent advances in gamma camera technology have provided opportunity for improved SPECT MPI protocols. A rapid Tl/Tc protocol that could improve image information while maintaining a low radiation burden for the patient would be desirable.
Methods
We compared high-speed SPECT MPI studies in 374 consecutive patients undergoing exercise or pharmacologic Tl/Tc protocol to those of 262 patients undergoing rest/stress Tc/Tc protocol.
Results
Tl/Tc imaging was accomplished in <20 min. Overall image quality was good to excellent in 96 % and 98 % of patients with the Tl/Tc and the Tc/Tc protocols, respectively (p = ns). Beginning rest imaging within 2 min after rest injection with the Tl/Tc protocol did not result in reduced confidence in image interpretation. Early rest Tc images of the Tl/Tc protocol showed less extracardiac activity than was observed on standard rest imaging used in the Tc/Tc protocol (84 % vs. 61 % ), respectively (p < 0.01). The normalcy rate was high in both groups (100 % vs. 92 % ). Radiation burden was similar between the Tl/Tc and Tc/Tc protocols.
Conclusions
A rapid stress Tl-201/rest Tc-99m protocol for use with high-speed SPECT MPI has image quality and radiation dosimetry similar to those observed with a conventional rest/stress Tc-99m protocol. The Tl/Tc protocol offers promise as an efficient and relatively low radiation dose method, in which the superior qualities of Tl-201 for stress imaging and of the Tc-99m agents for rest imaging can be preserved. The findings also suggest that with rapid imaging rest MPI immediately after Tc-99m agent injection may be superior to standard delayed image initiation.