Turgut Bulent, Unlu Mustafa, Cengel Atiye
Department of Nuclear Medicine, Cumhuriyet University School of Medicine, Sivas, Turkey.
Ann Nucl Med. 2005 Apr;19(2):115-22. doi: 10.1007/BF03027390.
The purpose of the present study was to evaluate the feasibility and diagnostic accuracy of same day short rest-dobutamine stress Tetrofosmin (TF) SPECT imaging protocol and to compare TF SPECT results with MIBI SPECT in the same subjects who were unable to perform treadmill exercise or were unsuitable for pharmacological vasodilator stress.
The study group consisted of 19 patients (2 female and 17 male, with a mean age of 53.8 +/- 7.9 yrs) in whom coronary artery disease (CAD) had been proven or excluded at coronary angiography (CA). MIBI SPECT imaging was performed first. TF SPECT images were obtained one week after MIBI imaging. Immediately after the rest SPECT imaging in both of the MIBI and TF studies, patients underwent dobutamine stress tests. Rest-stress radiotracer doses and dobutamine doses were the same for both TF and MIBI studies. While 60 min waiting periods were applied for MIBI study, only 30 min waiting periods were applied for TF study after the rest and stress injections. Images were evaluated by visual and quantitative analysis.
Dobutamine stress parameters were similar for both studies. Although in TF study, the time between radiopharmaceutical injection and imaging was shorter than in MIBI study, there was no significant difference between heart-to-liver (H/Li) and heart-to-lung (H/Lu) ratios. According to CA results, diagnostic accuracy was similar for TF and MIBI. While sensitivity, specificity and accuracy for TF study were calculated as 82%, 84% and 82%, respectively, the corresponding values for MIBI were 82%, 88% and 84%, respectively. This clinical study has shown comparable diagnostic performance for the detection of CAD between MIBI and TF. Good correlation was found between segmental analysis for both studies.
MIBI and TF showed similar perfusion defects and good segmental correlation during dobutamine stress with the same quality images. Both radiopharmaceuticals may be acceptable with this imaging protocol. Besides this, TF study showed better reversibility degree (55%) in a shorter time when compared to MIBI study (25%) in perfusion defects (especially in segments with severely decreased perfusion or no uptake).
本研究旨在评估当日短期静息 - 多巴酚丁胺负荷四碘荧光素（TF）单光子发射计算机断层显像（SPECT）成像方案的可行性和诊断准确性，并在无法进行平板运动或不适合使用药物血管扩张剂负荷的同一受试者中，将TF SPECT结果与甲氧基异丁基异腈（MIBI）SPECT结果进行比较。
研究组由19例患者（2例女性和17例男性，平均年龄53.8±7.9岁）组成，这些患者在冠状动脉造影（CA）中已证实或排除冠状动脉疾病（CAD）。首先进行MIBI SPECT成像。TF SPECT图像在MIBI成像一周后获得。在MIBI和TF研究的静息SPECT成像后，患者立即进行多巴酚丁胺负荷试验。TF和MIBI研究的静息 - 负荷放射性示踪剂剂量和多巴酚丁胺剂量相同。MIBI研究应用60分钟等待期，而TF研究在静息和负荷注射后仅应用30分钟等待期。图像通过视觉和定量分析进行评估。
两项研究的多巴酚丁胺负荷参数相似。虽然在TF研究中，放射性药物注射与成像之间的时间比MIBI研究短，但心 - 肝（H/Li）和心 - 肺（H/Lu）比值之间无显著差异。根据CA结果，TF和MIBI的诊断准确性相似。TF研究的敏感性、特异性和准确性分别计算为82%、84%和82%，MIBI的相应值分别为82%、88%和84%。这项临床研究表明，MIBI和TF在检测CAD方面具有可比的诊断性能。两项研究的节段分析之间发现良好的相关性。
MIBI和TF在多巴酚丁胺负荷期间显示出相似的灌注缺损和良好的节段相关性，图像质量相同。两种放射性药物在这种成像方案下可能都是可接受的。除此之外，与MIBI研究（25%）相比，TF研究在灌注缺损（特别是在灌注严重降低或无摄取的节段）中在更短时间内显示出更好的可逆程度（55%）。
