The Korean Journal of Nuclear Medicine (대한핵의학회지)

The Korean Society of Nuclear Medicine (대한핵의학회)
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Quantitative Analysis of Thallium-201 Myocardial Tomograms

Thallium-201 심근 단층영상의 정량적 분석

  • Kim, Sang-Eun (Department of Internal Medicine, College of Medicine Seoul National University) ;
  • Nam, Gi-Byoung (Department of Internal Medicine, College of Medicine Seoul National University) ;
  • Choi, Chang-Woon (Department of Internal Medicine, College of Medicine Seoul National University) ;
  • Choi, Kee-Joon (Department of Internal Medicine, College of Medicine Seoul National University) ;
  • Lee, Dong-Soo (Department of Internal Medicine, College of Medicine Seoul National University) ;
  • Sohn, Dae-Won (Department of Internal Medicine, College of Medicine Seoul National University) ;
  • Ahn, Cu-Rie (Department of Internal Medicine, College of Medicine Seoul National University) ;
  • Chung, June-Key (Department of Internal Medicine, College of Medicine Seoul National University) ;
  • Lee, Myoung-Mook (Department of Internal Medicine, College of Medicine Seoul National University) ;
  • Lee, Myung-Chul (Department of Internal Medicine, College of Medicine Seoul National University) ;
  • Park, Young-Bae (Department of Internal Medicine, College of Medicine Seoul National University) ;
  • Choi, Yun-Shik (Department of Internal Medicine, College of Medicine Seoul National University) ;
  • Seo, Jung-Don (Department of Internal Medicine, College of Medicine Seoul National University)
  • 김상은 (서울대학교 의과대학 내과학교실) ;
  • 남기병 (서울대학교 의과대학 내과학교실) ;
  • 최창운 (서울대학교 의과대학 내과학교실) ;
  • 최기준 (서울대학교 의과대학 내과학교실) ;
  • 이동수 (서울대학교 의과대학 내과학교실) ;
  • 손대원 (서울대학교 의과대학 내과학교실) ;
  • 안규리 (서울대학교 의과대학 내과학교실) ;
  • 정준기 (서울대학교 의과대학 내과학교실) ;
  • 이명묵 (서울대학교 의과대학 내과학교실) ;
  • 이명철 (서울대학교 의과대학 내과학교실) ;
  • 박영배 (서울대학교 의과대학 내과학교실) ;
  • 최윤식 (서울대학교 의과대학 내과학교실) ;
  • 서정돈 (서울대학교 의과대학 내과학교실)
  • Published : 1991.12.31
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Abstract

The purpose of this study was to assess the ability of quantitative Tl-201 tomography to identify and localize coronary artery disease (CAD). The study population consisted of 41 patients (31 males, 10 females; mean age $55{\pm}7$ yr) including 14 with prior myocardial infarction who underwent both exercise Tl-201 myocardium SPECT and coronary angiography for the evaluation of chest pain. From the short axis and vertical long axis tomograms, stress extent polar maps were generated by Cedars-Sinai Medical Center program, and the % stress defect extent (SDE) was quantified for each coronary artery territory. For the purpose of this study, the coronary circulation was divided into 6 arterial segments, and the "myocardial ischemic score" (MIS) was calculated from the coronary angiogram. Sensitivity for the detection of CAD ($\geq50%$ coronary stenosis by angiography) by angiography) by stress extent polar map was 95% in single vessel disease, and 100% in double and triple vessel deseases. Overall sensitivity was 97%. Sensitivity and specificity for the detection of individual diseased vessels were, respectively, 87% and 90% for the left anterior descending artery (LAD), 36% and 93% for the left circumflex artery (LCX), and 71% and 70% for the right coronary artery (RCA). Concordance for the detection of individual diseased vessels between the coronary angiography and stress polar map was fair for the LAD (kappa=0.70), and RCA (kappa=0.41) lesions, whereas it was poor for the LCX lesions (kappa : 0.32). There were siginificant correlations between the MIS and SDE in LAD (rs=0.56, p=0.0027), and RCA territory (rs=0.60, p=0.0094). No significant correlation was found in LCX territory. When total vascular territories were combined, there was a significant correlation between the MIS and SDE (rs=0.42, p=0.0116). In conclusion, the quantitative analysis of Tl-201 tomograms appears to be accurate for determining the presence and location of CAD.

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