Related Experiment Videos
Gated thallium scintigraphy in patients with coronary artery disease: an improved planar imaging technique
W Martin1, A C Tweddel, A I McGhie
1Department of Medical Cardiology, Royal Infirmary, Glasgow, Scotland.
Insights
Electrocardiographic gating improves thallium scanning for assessing myocardial perfusion and left ventricular function. This enhanced gated thallium scanning improves detection of coronary artery disease with higher predictive accuracy.
Area of Science:
- Cardiology
- Nuclear Medicine
- Diagnostic Imaging
Background:
- Thallium scanning is established for myocardial perfusion assessment.
- Standard static images suffer from blurring due to myocardial contraction.
Purpose of the Study:
- To evaluate the utility of electrocardiographic gating in thallium scanning.
- To improve the assessment of regional myocardial perfusion and left ventricular function.
- To enhance the non-invasive detection of significant coronary artery disease.
Main Methods:
- Acquisition of multiple view gated thallium scans using electrocardiographic gating and a high sensitivity collimator.
- Display of images on cine loop.
- Evaluation in 100 patients undergoing coronary arteriography and 14 volunteers.
Main Results:
- Improved visual assessment of regional myocardial perfusion with reduced interobserver variability.
- Acquisition of accurate information on left ventricular function.
- Improved detection of significant coronary artery disease with no loss of specificity compared to static images.
- Increased predictive accuracy from 85% to 94% with gated imaging.
Conclusions:
- Gated thallium scanning offers improved assessment of myocardial perfusion and left ventricular function.
- This technique enhances the non-invasive detection of significant coronary artery disease.
- Gated thallium scanning is readily applicable with no extra cost and improved predictive accuracy.
Abstract:
The use of thallium scanning in the assessment of myocardial perfusion is well established. However, myocardial contraction leads to significant blurring of standard static images. By using electrocardiographic gating and a high sensitivity collimator, multiple view gated scans can be acquired prior to thallium redistribution. Reporting of these images on cine loop display in 100 consecutive patients undergoing coronary arteriography and 14 volunteers results in improved visual assessment of regional myocardial perfusion (with reduced interobserver variability) and, in addition, yields useful and accurate information on left ventricular function. The combination of better assessment of perfusion and information on wall motion results in improved detection of patients with significant coronary disease with no loss of specificity when compared with static images. Predictive accuracy improves from 85% to 94% with gated imaging. Gated thallium scanning could be readily applied in most centres using thallium at no extra cost and with improved predictive accuracy in the non-invasive detection of significant coronary disease.