Document Detail

Quantitative analysis of seven-pinhole tomographic thallium-201 scintigrams: improved sensitivity and estimation of the extent of coronary involvement by evaluation of radiotracer uptake and clearance.
MedLine Citation:
PMID:  6608548     Owner:  NLM     Status:  MEDLINE    
Recent studies have shown that the sensitivity of conventional thallium-201 scintigraphy can be increased by the quantitative assessment of myocardial radiotracer clearance rates in conjunction with the evaluation of radionuclide uptake. In this study, a similar analysis of tomographic scintigrams was performed to determine the feasibility and value of this approach, particularly in estimating the extent of disease and detecting three vessel coronary involvement. Seventy patients undergoing cardiac catheterization for chest pain were studied by exercise and 3 hour delayed thallium-201 scintigrams using the seven-pinhole tomographic technique. Each study was evaluated by visual inspection of the tomographic sections and quantitative analysis. The latter approach consisted of comparing circumferential profiles of the initial post-exercise radionuclide uptake and the 3 hour clearance rates generated from each of three left ventricular slices with similar profiles representing the lower 95% confidence limits derived from 15 middle-aged volunteers. An abnormality was considered present when a patient's profile fell below these limits for a 30 degrees arc, and was ascribed to disease in a particular artery when it involved that vessel's usual distribution. Among the 61 patients without apparent primary myocardial or valvular disease, the diagnostic sensitivity of thallium scintigraphy was increased from 86% (43 of 50) to 96% (48 of 50) without a change in specificity (both 9 of 11 or 82%). More importantly, the quantitative approach permitted detection of 85% (107 of 126) of significantly obstructed coronary vessels compared with 47% (59 of 126) by visual analysis (p less than 0.001), again without sacrificing specificity (85 versus 87%).(ABSTRACT TRUNCATED AT 250 WORDS)
B M Massie; J A Wisneski; M Hollenberg; E W Gertz; S Henderson
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  3     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1984 May 
Date Detail:
Created Date:  1984-05-17     Completed Date:  1984-05-17     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1178-86     Citation Subset:  IM    
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MeSH Terms
Coronary Disease / radiography,  radionuclide imaging*
Exercise Test
Middle Aged
Radioisotopes / diagnostic use*
Thallium / diagnostic use*
Tomography, Emission-Computed*
Grant Support
Reg. No./Substance:
0/Radioisotopes; 7440-28-0/Thallium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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