Identification of viable myocardium in patients with chronic coronary artery disease using rest-redistribution thallium-201 tomography: Optimal image analysis
Identification of viable myocardium in patients with chronic coronary artery disease using rest-redistribution thallium-201 tomography: Optimal image analysis(435 views) Pace L, Perrone-Filardi P, Mainenti PP, Cuocolo A, Vezzuto P, Prastaro M, Varrone A, De Luca G, Soricelli A, Betocchi S, Chiariello M, Salvatore M
References: Gibson, R.S., Watson, D.D., Taylor, G.J., Prospective assessment of regional myocardial perfusion before and after coronary revascularization surgery by quantitative thallium-201 scintigraphy (1983) J Am Coll Cardiol, 1, pp. 804-81
Melin, J.A., Wijns, W., Keyeux, A., Assessment of thallium-201 redistribution versus glucose uptake as a predictor of viability after coronary occlusion and reperfusion (1988) Circulation, 77, pp. 927-934
Yamamoto, K., Asada, S., Masuyama, T., Myocardial hibernation in the infarcted region cannot be assessed from the presence of stress-induced ischemia: Usefulness of delayed image of exercise thallium-201 (1993) Am Heart J, 125, pp. 33-40
Sabia, P.J., Powers, E.R., Ragosta, M., Smith, W.H., Watson, D.D., Kaul, S., Role of quantitative planar thallium-201 imaging for determining viability in patients with acute myocardial infarction and a totally occluded infarct-related artery (1993) J Nucl Med, 34, pp. 728-736
Liu, P., Kiess, M.C., Okada, R.D., The persistent defect on exercise thallium imaging and its fate after myocardial revascularization: Does it represent scar or ischemia (1985) Am Heart J, 110, pp. 996-1001
Kiat, H., Berman, D.S., Maddahy, J., Late reversibility of tomographic myocardial thallium-201 defects: An accurate marker of myocardial viability (1988) J Am Coll Cardiol, 12, pp. 1456-1463
Dilsizian, V., Rocco, T.P., Freeman, N.M., Leon, M.B., Bonow, R.O., Enhanced detection of ischemic but viable myocardium by the reinjection of thallium after stress-redistribution imaging (1990) N Engl J Med, 323, pp. 141-146
Ohtani, H., Tamaki, N., Yonekura, Y., Value of thallium-201 reinjection after delayed SPECT imaging for predicting reversible ischemia after coronary artery bypass grafting (1990) Am J Cardiol, 66, pp. 394-399
Ragosta, M., Beller, G.A., Watson, D.D., Kaul, S., Gimple, L.W., Quantitative planar rest-redistribution thallium-201 imaging in detection of myocardial viability and prediction of improvement in left ventricular function after coronary bypass surgery in patients with severely depressed left ventricular function (1993) Circulation, 87, pp. 1630-1641
Bax, J.J., Cornel, J.H., Visser, F.C., Prediction of recovery of myocardial dysfunction after revascularization. Comparison of fluorine-18 fluorodeoxyglucose/thallium-201 SPECT, thallium-201 stress-reinjection SPECT and dobutamine echocardiography (1996) J Am Coll Cardiol, 28, pp. 558-564
Arnese, M., Cornel, J.H., Salustri, A., Prediction of improvement of regional left ventricular function after surgical revascularization. A comparison of low-dose dobutamine echocardiography with single-photon emission computed tomography (1995) Circulation, 91, pp. 2748-2752
Haque, T., Furukawa, T., Takahashi, M., Kinoshita, M., Identification of hibernating myocardium by dobutamine stress echocardiography: Comparison with thallium-201 reinjection imaging (1995) Am Heart J, 130, pp. 553-563
Vanoverschelde, J.L.J., D'Hondt, A.M., Marwivk, T., Head-to head comparison of exercise-redistribution-reinjection thallium single-photon emission computed tomograhy and low dose dobutamine echocardiography for prediction of reversibility of chronic left ventricular ischemic dysfunction (1996) J Am Coll Cardiol, 28, pp. 432-442
Matsunari, I., Fujino, S., Taki, J., Quantitative rest technetium-99m tetrofosmin imaging in predicting functional recovery after revascularization: Comparison with rest-redistribution thallium-201 (1997) J Am Coll Cardiol, 29, pp. 1226-1233
Perrone-Filardi, P., Pace, L., Prastaro, M., Dobutamine echocardiography predicts improvement of hypoperfused dysfunctional myocardium after revascularization in patients with coronary artery disease (1995) Circulation, 91, pp. 2556-2565
Schiller, N.B., Shaha, P.M., Crawford, M., Recommendations for quantitation of the left ventricle by two-dimensional echocardiography (1989) J Am Soc Echocardiogr, 2, pp. 358-367
Berger, B.C., Watson, D.D., Burwell, L.R., Redistribution of thallium at rest with stable and unstable angina and the effect of coronary artery bypass surgery (1979) Circulation, 60, pp. 1114-1125
Iskandrian, A.S., Hakki, A., Kane, S.A., Rest and redistribution thallium-201 myocardial scintigraphy to predict improvement in left ventricular function after coronary arterial bypass grafting (1983) Am J Cardiol, 51, pp. 1312-1316
Udelson, J.E., Coleman, P.S., Metherall, J., Predicting recovery of severe regional dysfunction. Comparison of resting scintigraphy with thallium-201 and technetium-99m-sestamibi (1994) Circulation, 89, pp. 2552-2561
Qureshi, U., Nagueh, S.F., Afridi, I., Dobutamine echocardiography and quantitative rest-redistribution 201Tl tomography in myocardial hibernation. Relation of contractile reserve to 201Tl uptake and comparative prediction of recovery of function (1997) Circulation, 95, pp. 626-635
Matinho, N.V.S., Keogh, B.E., Costa, D.C., Lammerstma, A.A., Ell, P.J., Camici, P.G., Pathophysiology of chronic left ventricular dysfunction. New insight from the measurement of absolute myocardial blood flow and glucose utilization (1996) Circulation, 93, pp. 737-744
Coversano, A., Walsh, J.F., Geltman, E.M., Perez, J.E., Bergmann, S.R., Gropler, R.J., Delineation of myocardial stunning and hibernation by positron emission tomography in advanced croronary artery disease (1996) Am Heart J, 131, pp. 440-450
Weich, H.F., Strauss, H.W., Pitt, B., The extraction of thallium-201 by the myocardium (1977) Circulation, 56, pp. 188-191
Grunwald, A.M., Watson, D.D., Holzgrefe, H.H., Irving, J.F., Beller, G.A., Myocardial thallium-201 kinetics in normal and ischemic myocardium (1981) Circulation, 64, pp. 610-618
Uren, G.N.B., Melin, J.A., De Bruyne, B., Wijns, W., Baudhuin, T., Camici, P.G., Relation between blood flow and the severity of coronary artery stenosis (1994) N Engl J Med, 330, pp. 1782-1788
Gibson, R. S., Watson, D. D., Taylor, G. J., Prospective assessment of regional myocardial perfusion before and after coronary revascularization surgery by quantitative thallium-201 scintigraphy (1983) J Am Coll Cardiol, 1, pp. 804-81
Melin, J. A., Wijns, W., Keyeux, A., Assessment of thallium-201 redistribution versus glucose uptake as a predictor of viability after coronary occlusion and reperfusion (1988) Circulation, 77, pp. 927-934
Sabia, P. J., Powers, E. R., Ragosta, M., Smith, W. H., Watson, D. D., Kaul, S., Role of quantitative planar thallium-201 imaging for determining viability in patients with acute myocardial infarction and a totally occluded infarct-related artery (1993) J Nucl Med, 34, pp. 728-736
Liu, P., Kiess, M. C., Okada, R. D., The persistent defect on exercise thallium imaging and its fate after myocardial revascularization: Does it represent scar or ischemia (1985) Am Heart J, 110, pp. 996-1001
Bax, J. J., Cornel, J. H., Visser, F. C., Prediction of recovery of myocardial dysfunction after revascularization. Comparison of fluorine-18 fluorodeoxyglucose/thallium-201 SPECT, thallium-201 stress-reinjection SPECT and dobutamine echocardiography (1996) J Am Coll Cardiol, 28, pp. 558-564
Vanoverschelde, J. L. J., D'Hondt, A. M., Marwivk, T., Head-to head comparison of exercise-redistribution-reinjection thallium single-photon emission computed tomograhy and low dose dobutamine echocardiography for prediction of reversibility of chronic left ventricular ischemic dysfunction (1996) J Am Coll Cardiol, 28, pp. 432-442
Schiller, N. B., Shaha, P. M., Crawford, M., Recommendations for quantitation of the left ventricle by two-dimensional echocardiography (1989) J Am Soc Echocardiogr, 2, pp. 358-367
Berger, B. C., Watson, D. D., Burwell, L. R., Redistribution of thallium at rest with stable and unstable angina and the effect of coronary artery bypass surgery (1979) Circulation, 60, pp. 1114-1125
Iskandrian, A. S., Hakki, A., Kane, S. A., Rest and redistribution thallium-201 myocardial scintigraphy to predict improvement in left ventricular function after coronary arterial bypass grafting (1983) Am J Cardiol, 51, pp. 1312-1316
Udelson, J. E., Coleman, P. S., Metherall, J., Predicting recovery of severe regional dysfunction. Comparison of resting scintigraphy with thallium-201 and technetium-99m-sestamibi (1994) Circulation, 89, pp. 2552-2561
Matinho, N. V. S., Keogh, B. E., Costa, D. C., Lammerstma, A. A., Ell, P. J., Camici, P. G., Pathophysiology of chronic left ventricular dysfunction. New insight from the measurement of absolute myocardial blood flow and glucose utilization (1996) Circulation, 93, pp. 737-744
Weich, H. F., Strauss, H. W., Pitt, B., The extraction of thallium-201 by the myocardium (1977) Circulation, 56, pp. 188-191
Grunwald, A. M., Watson, D. D., Holzgrefe, H. H., Irving, J. F., Beller, G. A., Myocardial thallium-201 kinetics in normal and ischemic myocardium (1981) Circulation, 64, pp. 610-618
Uren, G. N. B., Melin, J. A., De Bruyne, B., Wijns, W., Baudhuin, T., Camici, P. G., Relation between blood flow and the severity of coronary artery stenosis (1994) N Engl J Med, 330, pp. 1782-1788
Identification of viable myocardium in patients with chronic coronary artery disease using rest-redistribution thallium-201 tomography: Optimal image analysis
With the widely used 50% threshold, sensitivity is high, but specificity is low in detecting viable myocardium on Tl-201 SPECT, In this study, we sought to identify the best threshold for semiquantitative Tl-201 analysis, Methods: Rest-redistribution Tl-201 SPECT was performed in 46 patients with chronic coronary artery disease before and after myocardial revascularization, Regional function was evaluated by two-dimensional echocardiography before and after myocardial revascularization using a 3-point scale (1 = normal, 2 = hypokinetic, 3 = a/dyskinetic), Myocardial segments with abnormal systolic function were defined as viable if the systolic function score decreased greater than or equal to 1 after myocardial revascularization, A second group of 12 patients with chronic coronary artery disease constituted the validation population. Sensitivity-specificity curves, as well as receiver operating characteristic curves, for rest and redistribution images were generated by varying the Tl-201 uptake threshold. Results: A 65% threshold uptake using resting images was found to be the best for detecting a/dyskinetic segments that improve after myocardial revascularization from those that do not improve. Sensitivity was lower with a 65% threshold (75%) than with a 50% threshold (90%, p < 0.05), but specificity was higher (76% versus 26%, p < 0.05) resulting in better accuracy (76% versus 57%, p < 0.05) and positive predictive value (77% versus 55%), while the negative predictive value was not different (69% versus 75%, p not significant). The area under the receiver operating characteristic curve was significantly (p < 005) larger for rest (0.80 +/- 0.05) as opposed to redistribution (0.72 +/- 0.05) images. Similar results were obtained in a subgroup of patients with low ejection fraction. Significant correlations between the percentage of revascularized viable segments and both the change in ejection fraction and in postrevascularization ejection fraction were found. When these findings were applied in the validation group, a gain in specificity accuracy and positive predictive value was obtained with the 65% threshold compared with the 50% threshold. Conclusion: This study demonstrated that analysis of resting images and use of the 65% Tl-201 uptake threshold is preferable for separating viable from not viable dyssynergic myocardial segments in patients with chronic coronary artery disease.
Identification of viable myocardium in patients with chronic coronary artery disease using rest-redistribution thallium-201 tomography: Optimal image analysis
Identification of viable myocardium in patients with chronic coronary artery disease using rest-redistribution thallium-201 tomography: Optimal image analysis
Hesse B, Tagil K, Cuocolo A, Anagnostopoulos C, Bardies M, Bax J, Bengel F, Busemann Sokole E, Davies G, Dondi M, Edenbrandt L, Franken P, Kjaer A, Knuuti J, Lassmann M, Ljungberg M, Marcassa C, Marie PY, Mckiddie F, O'connor M, Prvuolovich E, Underwood R * 3. 0 T perfusion MR imaging(731 views) Rivista Di Neuroradiologia (ISSN: 1120-9976), 2004; 17(6): 807-812. Impact Factor:0.023 ViewExport to BibTeXExport to EndNote