A new method for quantification of pulmonary thallium uptake in myocardial SPECT studies

Quantified pulmonary thallium 201 (Tl) uptake was assessed in 32 normal subjects and 66 patients with suspected coronary artery disease (CAD) by a new method utilizing SPECT acquisition data. In 26 subjects pulmonary uptake was assessed with both SPECT and planar techniques. Pulmonary/myocardial (PM) ratios for the whole right lung (PM1) and for the upper left lung (PM2) were computed and compared with stress test, coronary angiography, radionuclide angiography (ERNA), and quantified Tl single photon emission computed tomography (SPECT) results. Excellent correlation between pulmonary uptake assessed by planar and SPECT technique was disclosed (r = 0.92). The PM ratios (PM1/PM2) sensitivity and specificity in patients with CAD were 88%/92% and 60%/70%, for predicting perfusion abnormalities 90%/87% and 88%/88%, and an inverse correlation to left ventricular ejection fraction (LVEF) was found (r = -0.40/r = -0.37, P less than 0.01). Significant correlations to coronary angiography findings (r = 0.54/r = 0.49, P less than 0.001) and to number of vessel territories with abnormal perfusion (r = 0.70/r = 0.69, P less than 0.001) were seen. Thus, pulmonary Tl uptake can be assessed in SPECT studies. The new method's discriminative ability seems higher than that of the standard planar techniques currently employed. Positive correlations to coronary angiography findings and even stronger ones to perfusion abnormalities were observed.