[Evaluation of ischemic heart disease using the index of relative 99mTc-tetrofosmin uptake increase at exercise]

We calculated an increase of myocardial 99mTc-tetrofosmin uptake during exercise from resting condition, which was thought to reflect coronary flow reserve, and assessed whether this method enhanced the detection of coronary artery disease (CAD). Exercise myocardial SPECT was performed using 99mTc-tetrofosmin with one-day method (exercise-rest) in 26 patients. Twenty-one patients were suspected to have ischemic heart disease and 5 were control patients. A polar map was used to evaluate the increase in counts after exercise. The parameter of % uptake increase was obtained by the ratio of exercise and resting myocardial counts. The uptake was corrected for administration dose and time decay between the exercise and rest studies. The sensitivity for detecting patients with significant coronary stenosis by visual evaluation and % uptake increase map was 60% and 90%, respectively. In 5 patients, % uptake increase map detected stenosed coronary artery lesions that could not be detected by visual analysis. We concluded that the % uptake increase map combined with conventional SPECT images enhanced the detectability of coronary artery disease and the evaluation of the degree of coronary flow reserve.