Thallium-201 myocardial scintigraphy: a critical comparison of seven-pinhole tomography and conventional planar imaging.

Seven-pinhole tomographic and planar thallium-201 imaging was performed on 63 consecutive patients to assess the clinical value of these techniques. Significant coronary artery disease (stenosis greater than or equal to 70%) was present in 52 patients. Comparing the seven-pinhole results with those of the planar, the findings for sensitivity, specificity, and inter- and intraobserver agreement were, respectively, 94% against 75% (p less than 0.005), 91% against 91%, 86% against 79%, and 97% against 92%. In 25 patients in this group with a prior myocardial infarction, sensitivity was 100% for tomographic imaging and 92% for planar. In 27 patients without prior myocardial infarction, by contrast, sensitivity for tomographic imaging was 89% and for planar imaging 59% (p less than 0.01). Thus we conclude that both tomographic and planar imaging are highly sensitive for the detection of significant coronary artery disease, but tomographic imaging is significantly more sensitive in patients without prior myocardial infarction.