Gamma camera quantitation of thallium-210 redistribution at rest in a dog model

Defects seen at rest on thallium-201 (201TI) scintigraphy can disappear over time. We obtained sequential 5-minute scans over 127 +/- 9.4 minutes in seven open-chest dogs with fixed, stable regional flow reductions (normal zone flow 0.76 +/- 0.09 ml g-1/min, ischemic zone flow 0.49 +/- 0.04 ml g-1 min [mean +/- SEM], p less than 0.05) as determined by microsphere injection. Sequential 5-minute scans were obtained after i.v. injection of 1.5 mCi of 201TI. Data were stored in a 64 x 64 pixel computer matrix. Qualitatively, defects that showed redistribution were seen in all dogs. Quantitatively, greater count loss from peak activity distinguished the normal zone, but overlap was great. Alternate quantitative methods using background subtraction altered the characteristics of the time-activity curves, but did not enhance the separation of ischemic from normal zones. Patterns of 201TI redistribution from gamma camera imaging are profoundly influenced by the method of quantitation. No single method of quantitative analysis separated ischemic from normal zones in all dogs. The clinical significance of patterns at rest requires redefinition.