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European multi-centre comparison of thallium 201 and technetium 99m methoxyisobutylisonitrile in ischaemic heart
M N Maisey1, A Lowry, A Bischof-Delaloye
1Division of Radiological Sciences, UMDS, Guy's Hospital, London Bridge, UK.
Insights
Technetium 99m methoxyisobutylisonitrile (99mTc-MIBI) is as accurate as thallium 201 (201Tl) for detecting coronary artery disease (CAD). Both agents showed high concordance in identifying myocardial segments and diagnosing CAD in patients.
Area of Science:
- Nuclear Medicine
- Cardiology
- Radiopharmaceutical Imaging
Background:
- Coronary artery disease (CAD) diagnosis relies on accurate imaging.
- Thallium 201 (201Tl) chloride perfusion scanning is a standard for CAD detection.
- Technetium 99m methoxyisobutylisonitrile (99mTc-MIBI) offers potential advantages in nuclear cardiology.
Purpose of the Study:
- To compare the diagnostic accuracy of 99mTc-MIBI with 201Tl for detecting coronary artery disease (CAD).
- To evaluate the concordance between 99mTc-MIBI and 201Tl in assessing myocardial segments and patient diagnoses.
Main Methods:
- A multi-centre study involving 56 patients across Europe.
- Comparative analysis of myocardial perfusion scans using 99mTc-MIBI and 201Tl.
- Assessment of accuracy in detecting CAD in myocardial segments and total arteries.
Main Results:
- High concordance observed between 99mTc-MIBI and 201Tl, with 81% agreement in myocardial segments and 80% in patient diagnoses.
- Overall CAD detection rates were 98% for 201Tl and 96% for 99mTc-MIBI.
- Detection rates for CAD in total arteries were 68% for both agents, indicating comparable efficacy.
Conclusions:
- 99mTc-MIBI demonstrates equivalent accuracy to 201Tl for the detection of coronary artery stenoses.
- 99mTc-MIBI is a viable alternative to 201Tl in the diagnosis of coronary artery disease.
- The study supports the use of 99mTc-MIBI in clinical practice for CAD assessment.
Abstract:
Fifty-six patients in Europe were entered into a multi-centre study to compare the accuracy of technetium 99m methoxyisobutylisonitrile (99mTc-MIBI) for the detection of coronary artery disease (CAD) with thallium 201 (201Tl) chloride perfusion scanning. The results showed a high degree of concordance between the two radiopharmaceuticals. Some 81% (678/840) of myocardial segments showed the same result (normal, infarct or ischaemia), and 80% (45/56) of patients had the same diagnosis. Overall detection of CAD in patients was 98% for 201T1 and 96% for 99mTc-MIBI. Detection of CAD in total arteries was 68% for both agents. In this study 99mTc-MIBI was as accurate as 201Tl for the detection of coronary artery stenoses.