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Quantitative thallium-201 single-photon emission computed tomography during maximal pharmacologic coronary

S Nishimura1, J J Mahmarian, T M Boyce

  • 1Department of Internal Medicine, Baylor College of Medicine, Houston, Texas.

Journal of the American College of Cardiology
|September 1, 1991
PubMed

Insights

Quantitative thallium-201 SPECT combined with adenosine infusion effectively diagnoses coronary artery disease. This method accurately identifies stenosis and affected regions, even in multivessel disease cases.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Diagnostic Imaging

Background:

  • Coronary artery disease (CAD) diagnosis relies on invasive and non-invasive methods.
  • Pharmacologic stress testing enhances the diagnostic accuracy of myocardial perfusion imaging.
  • Adenosine-induced vasodilation is a key pharmacologic stressor in SPECT imaging.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of thallium-201 SPECT with adenosine infusion for detecting CAD.
  • To assess the sensitivity and specificity of quantitative analysis and polar maps in identifying coronary stenoses.
  • To correlate perfusion defect extent with the severity of coronary artery disease.

Main Methods:

  • 101 patients with suspected CAD underwent thallium-201 SPECT during maximal pharmacologic vasodilation with intravenous adenosine.
  • Coronary arteriography was performed concurrently for gold-standard comparison.
  • Tomographic images were analyzed visually and quantitatively using computer-generated polar maps.

Main Results:

  • Quantitative thallium-201 SPECT demonstrated high sensitivity (87%) and specificity (90%) for detecting CAD (defined as >50% stenosis).
  • Sensitivity was particularly high in patients with prior myocardial infarction (96%) and varied by vessel involvement (76%-90%).
  • The extent of perfusion defects on polar maps correlated directly with the extent of coronary artery disease.

Conclusions:

  • Quantitative thallium-201 SPECT during adenosine infusion is a sensitive and specific tool for diagnosing CAD.
  • This technique effectively localizes coronary stenoses and identifies affected vascular regions, including in multivessel disease.
  • The findings support the use of adenosine stress thallium-201 SPECT for comprehensive CAD assessment.

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