[Nuclear medical methods for the detection of coronary disease]

Three developments in recent years have speeded the advance of nuclear cardiology: gamma cameras have become available, computers have been introduced into nuclear medicine, and radionuclides such as Tc99m and Tl201 have become easily obtainable for imaging purposes. The imaging of the myocard with Tl201 has its established place in cardiology. Sensitivities of about 90% and specificities of about 80-90% make Tl201 exercise tests a powerful tool for detection of coronary artery disease (CAD) in a preselected population. Ejection fraction can be measured at rest and during exercise where an absent increase during physical stress is clearly abnormal (and also not necessarily specific for CAD). Sensitivities of 80-90% and specificities around 90% for detection of CAD seem possible. Wall motion abnormalities again can be brought out during exercise and serve to localize impaired ventricle function. Tc99m-pyrophosphate studies seem to have some implications to prognosis if myocardial accumulation persists. Only preliminary reports are thus far available for these two studies.