Abstract
Tl-201 myocardial scintigraphy (Tl study) tends to be attenuated by soft tissues (such as the diaphragm) due to its low energy emission. 99mTc-sestamibi (2-methoxy isobutyl isonitrile) is a relatively new agent with a higher energy emission and this characteristic accounts for the higher quality of 99mTc-sestamibi images. The purpose of this study is to evaluate the ability of 99mTc-sestamibi in alleviating the inferior attenuation of Tl studies. 99mTc-sestamibi SPECT myocardial scintigraphy was performed on 13 patients with inferior wall perfusion defects as determined by Tl study (but with normal coronary artery as evidenced by cardiac catheterization). All patients underwent Tl SPECT study using a standard procedure. Same-day protocol (rest-stress sequence) was used for 99mTc-sestamibi SPECT imaging. All images were analyzed by two independent observers. The results of our study reveal that 99mTc-sestamibi produced better images. The inferior wall perfusion defects in the Tl study were noted in one case only (l/13)in the 99mTc-sestamibi study. Our study suggests that 99mTc-sestamibi can remarkably reduce the inferior attenuation of Tl study.
Similar content being viewed by others
References
Lebowitz E, Greene MW, Fairchild R et al.: Thallium-201 for medical use. J Nucl Med 1975; 16: 151–5.
Johnstone DE, Wacker FJT, Berger HJ et al. Effect of patient positioning on left lateral thallium-201 myocardial image. J Nucl Med 1979; 20: 183–8.
Gordon DG, Pfisteren M, William R et al. The effect of diaphragmatic attenuation on Tl-201 images. Clin Nucl Med 1979; 4: 150–1.
Taillefer R, Gegnon A, Laglamme L et al. Same day injection of Tc-99m hexamibi for myocardial tomographic imaging: comparison between rest-stress and stress-rest injection sequences. Eur J Nucl Med 1989; 15: 113–7.
English RJ, Kozlowski J, Tumeh SS et al. Technetium myocardial perfusion agents: An introduction. J Nucl Med Tech 1987; 15: 138–43.
Deutsch E, Glavan KA, Sodd VJ et al. Cationic Tc-99m complexes as potential myocardial imaging agents. J Nucl Med 1981; 22: 897–907.
Deutsch E, Bushong W, Glavan KA et al. Heart imaging with cationic complexes of technetium. Science 1981; 218: 85–86.
Nishiyana H, Deutsch E, Adolph RJ et al. Basal kinetic studies of Tc-99m DMPE as a myocardial imaging agent in the dog. J Nucl Med 1982; 23: 1093–1101.
Dudszak R, Angelberger P, Homan R et al. Evaluation of 99m-Tc-dichlorodisl,2-dimethyl-phosphino) ethane (99m-Tc-DMPE) for myocardial scintigraphy in man. Eur J Nucl Med 1983; 8: 513–515.
Vanderheyden JL, Deutsch E, Libson K et al. Synthesis and characterization of [99m-Tc(dmpe)3)]+, a potential myocardial imaging agent (abstr). J Nucl Med 1983; 24: P9.
DePuey EG, Garcia EV, Alazraki NP et al. Comparison of Tl-201 and 99mTc-MIBI for quantitative cardiac SPECT (abstr). J Nucl Med 1988; 29: 793.
Kiat H, Maddahi J, Mers R et al. Comparison of 99mTcMIBI with Tl-201 imaging by planar and SPECT for assessment of coronary disease (abstr). J Nucl Med 1988; 29: 793.
Karcher G, Bertrand A, Moretti JL et al. Comparison study by two independent observers of the uptake abnormalites of Tl-201 and 99mTc-MlBI in 81 patients with coronary artery disease (abstr). J Nucl Med 1988; 29: 793–4.
Wackers FJ, Berman DS, Maddahi J et al. Technetium-99m hexakis 2-methoxyisobuty, isonitrile: human biodistribution, dosimetry, safety, and preliminary comparison to thallium for myocardial perfusion imaging. J Nucl Med 1989; 301–11.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Wang, S.J., Chen, Y.T., Hwang, C.L. et al. 99mTc-sestamibi can improve the inferior attenuation of TL-201 myocardial spect imaging. Int J Cardiac Imag 9, 87–92 (1993). https://doi.org/10.1007/BF01151432
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01151432