Myocardial imaging with thallium-201: the controversy over its clinical usefulness in ischemic heart disease.

Several uses of thallium myocardial imaging (assessment of questionable stenosis and detection of infarction) provide unique information and are useful adjuncts in the diagnostic workup and treatment of patients with coronary artery disease. Screening studies with thallium to detect the presence or absence of coronary artery disease have generated considerable controversy. Much of this conflict can be resolved by a careful analysis of the purpose of the screening study, the sensitivity and specificity of the imaging test, and the prevalence of disease in the subgroup under study. With the principles outlined, thallium imaging can be used to make patient-care decisions with a reasonable degree of confidence.