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Myocardial Tracer Uptake in SPECT Images after Direct Intracoronary Injection Of TI-201: Comparison with Stress-Reinjection Images  

Seo, Ji-Hyoung (Department of Nuclear Medicine School of Medicine, Kyungpook National University)
Kang, Seong-Min (Department of Nuclear Medicine School of Medicine, Kyungpook National University)
Bae, Jin-Ho (Department of Nuclear Medicine School of Medicine, Kyungpook National University)
Lee, Yong-Jin (Department of Nuclear Medicine School of Medicine, Kyungpook National University)
Lee, Sang-Woo (Department of Nuclear Medicine School of Medicine, Kyungpook National University)
Yoo, Jeong-Soo (Department of Nuclear Medicine School of Medicine, Kyungpook National University)
Ahn, Byeong-Cheol (Department of Nuclear Medicine School of Medicine, Kyungpook National University)
Cho, Yong-Geun (Department of Internal Medicine School of Medicine, Kyungpook National University)
Lee, Jae-Tae (Department of Nuclear Medicine School of Medicine, Kyungpook National University)
Publication Information
Nuclear Medicine and Molecular Imaging / v.41, no.4, 2007 , pp. 291-298 More about this Journal
Abstract
Purpose: To investigate the feasibility of TI-201 SPECT with intra coronary injection (lC-I) in the detection of viable myocardium, we have performed SPECT imaging after direct intracoronary injection of TI-201 and images were compared with those of stress-reinjection (Re-I) SPECT. Methods: Fourteen coronary artery disease patients (male 11, mean age 54 years) who had myocardial infarction or demonstrated left ventricular wall motion abnormality on echocardiography were enrolled. Three mCi of TI-201 was injected into both coronary arteries during angiography and images were acquired between 6- and 24-hour after injection. Reinjection imaging with 1 mCi of TI-201 was performed at 4-hour after adenosine stress imaging with 3 mCi of TI-201. Images were interpreted according to 4-grade visual scoring system (grade 0-3). Segments with mild to moderated uptake (${\leq}$grade 1), and upgraded more than one score with reinjection, and were defined as viable myocardium. Results: Image quality was poor in two cases with IC-I. Numbers of non-viable segments were 60 (23.8%) with IC-I, and 38 (15.1%) with Re-I, respectively. Overall agreement for perfusion grade per myocardial segment in each IC-I and Re-I was 76.5%. Overall agreement for viable segment between IC-I and Re-I was 90.5%. Only one out of 38 segments interpreted as non-viable with Re-I were interpretated as viable with IC-I. And 23 out of 214 segments interpreted as viable with Re-I were interpreted as non-viable with IC-I. Conclusion: Intracoronary TI-201 SPECT seemed to be not advantageous over stress-rest reinjection imaging in the assessment of myocardial viability, mainly due to low count statistics at 6-hour or 24-hour delayed time points. The feasibility of intracoronary TI- 201 SPECT is considered to be limited.
Keywords
coronary artery disease; intracoronary TI-201 injection; myocardial perfusion SPECT; myocardial viability;
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