Key result
99Tcm-MIBI SPECT yields ~55% normal septal uptake in LBBB, suggesting fewer false positives than 201Tl.
Why the study?
Frequent false positive septal findings of 201Tl stress imaging occur in patients with LBBB even without significant CAD, necessitating evaluation of 99Tcm-MIBI SPECT specificity.
Does stress/rest 99Tcm-MIBI SPECT accurately evaluate coronary artery disease without false positive septal findings in patients with constant complete LBBB?
Observational (n=22)
Does stress/rest 99Tcm-MIBI SPECT accurately evaluate coronary artery disease without false positive septal findings in patients with constant complete LBBB?
99Tcm-MIBI SPECT may be more specific and accurate than 201Tl for evaluating coronary artery disease in patients with LBBB due to fewer false positive septal findings.
MIBI SPECT yields few reversible septal defects in LBBB; leaves open whether it improves CAD specificity versus thallium.
Numerous studies have revealed frequent false positive septal findings of 201Tl stress imaging in patients with left bundle branch block (LBBB) even with angiographically excluded significant coronary artery disease (CAD). To scrutinize this phenomenon for stress/rest 99Tcm-methoxyisobutylisonitrile (MIBI) single photon emission computed tomography (SPECT) was used to review 22 patients with constant LBBB. The findings were reversible septal defect in one patient, partially reversible septal defect in one patient and irreversible septal defects in eight patients. In four patients 99Tcm-MIBI scans were entirely normal. Thus, 12/22 (55%) patients revealed normal septal 99Tcm-MIBI uptake. Both patients with a stress-induced septal defect revealed a significant left anterior descending artery stenosis on coronary angiography. These preliminary results suggest, that 99Tcm-MIBI might be more specific and accurate than 201Tl in the evaluation of CAD in patients with LBBB because of apparently rare or absent false positive septal findings.
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Altehoefer et al. (1993) conducted an observational in Constant complete left bundle branch block (LBBB) (n=22). 99Tcm-methoxyisobutylisonitrile (MIBI) stress/rest SPECT was evaluated on Normal septal 99Tcm-MIBI uptake. Stress/rest 99Tcm-MIBI SPECT demonstrated normal septal uptake in 55% (12/22) of patients with constant LBBB, suggesting fewer false positive septal findings compared to 201Tl imaging.
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