Document Detail

Planar 201Tl scintigraphy in ischaemic heart disease: a critical re-evaluation of qualitative and quantitative data analysis.
MedLine Citation:
PMID:  8370238     Owner:  NLM     Status:  MEDLINE    
The aims of the present study were to examine the observer agreement of qualitative (visual) and quantitative (computer-assisted) analysis of planar 201Tl imaging and to compare the diagnostic values of these methods in the detection of infarcted and exercise-induced ischaemic myocardium. The study population comprised of 119 patients (aged 24-77 years) referred consecutively for stress thallium scintigraphy for either diagnostic reasons (n = 42, 35%) or for further evaluation of known coronary artery disease (CAD) (n = 77, 65%). The interobserver agreement was low with the qualitative method and significantly higher with the quantitative method: Kappa-values 0.29-0.39 vs. 0.80-0.92, P < 0.00001. Sensitivity and specificity for the detection of previous Q-wave infarct was significantly higher with the quantitative method (94% and 94%) compared to the qualitative method (77% and 74%), P < 0.01. The corresponding predictive values of a positive and a negative test were 96% and 92% vs. 80% and 70% (P < 0.01). In 86 patients in whom coronary angiography was performed the two methods did not differ significantly regarding sensitivity, specificity and predictive values for the diagnosis of reversible ischaemia or rather CAD. However, when 22 patients with a maximal exercise heart rate < 80% of the predicted target heart rate were excluded the sensitivity was increased with both techniques and was significantly higher with the quantitative method. We conclude that qualitative image analysis has an unacceptably low reproducibility and that quantitative image analysis increases the diagnostic value of 201Tl scintigraphy considerably in both the detection of previous infarcts and, provided a sufficient exercise level is achieved, in the disclosure of reversible myocardial ischaemia.
F Pedersen; A Rabøl; S S Sørensen; P F Høilund-Carlsen; J K Madsen; F Efsen; E Sandøe
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical physiology (Oxford, England)     Volume:  13     ISSN:  0144-5979     ISO Abbreviation:  Clin Physiol     Publication Date:  1993 Jul 
Date Detail:
Created Date:  1993-10-12     Completed Date:  1993-10-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8309768     Medline TA:  Clin Physiol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  397-408     Citation Subset:  IM    
Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, University of Copenhagen, Denmark.
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MeSH Terms
Coronary Angiography
Exercise Test
Heart / radiography,  radionuclide imaging*
Image Processing, Computer-Assisted
Middle Aged
Myocardial Infarction / radiography,  radionuclide imaging
Myocardial Ischemia / radiography,  radionuclide imaging*
Observer Variation
Sensitivity and Specificity
Thallium Radioisotopes / diagnostic use
Reg. No./Substance:
0/Thallium Radioisotopes

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