Key result
Dynamic Tc-99m-sestamibi SPECT correlates strongly with O-15 water PET for regional myocardial flow reserve.
Why the study?
A method for quantitative estimation of myocardial blood flow index and myocardial flow reserve using Tc-99m-sestamibi imaging was needed to enable assessment without PET cameras.
Does Tc-99m-sestamibi imaging accurately estimate regional myocardial blood flow and flow reserve compared to O-15 water PET in patients with suspected coronary artery disease?
Observational (n=29)
Single-blind
No
Does Tc-99m-sestamibi imaging accurately estimate regional myocardial blood flow and flow reserve compared to O-15 water PET in patients with suspected coronary artery disease?
Effect estimate: R=0.838
p-value: p=<0.0001
Dynamic Tc-99m-sestamibi imaging can estimate regional myocardial blood flow and flow reserve, offering a potential alternative to PET for detecting functional severity of coronary lesions.
Dynamic SPECT may offer a feasible PET alternative for flow reserve; leaves open prospective outcome validation.
BACKGROUND: The aims of this study were to develop a method for quantitative estimation of the myocardial blood flow index (MBFI) and myocardial flow reserve (MFR) of the whole left ventricle using (99m)technetium (Tc-99m)-sestamibi imaging. METHODS AND RESULTS: Twenty-two patients with suspected coronary artery disease and 7 controls underwent both Tc-99m-sestamibi imaging and O-15 water positron emission tomography (PET). The global MBFI was calculated on the basis of the microsphere model from the ratio of the myocardial count to the area under the time - activity curve on the aortic arch. The regional MBFI was calculated from the relative distributions of Tc-99m-sestamibi uptake values. The regional MBFI and MFR (Tc-MFR) obtained using single-photon emission computed tomography were compared with the myocardial blood flow (MBF) and MFR (PET-MFR) obtained using PET as the gold standard. Regional MBFI significantly correlated with the MBF obtained using PET. Regional Tc-MFR also correlated with the regional PET-MFR, with some underestimation. CONCLUSION: These results indicate that regional MBF and MFR may be estimated by dynamic Tc-99m-sestamibi imaging and can be used for the early detection and estimation of the functional severity of coronary lesions without the need for a PET camera.
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Tsukamoto et al. (2005) conducted an observational in Suspected coronary artery disease (n=29). Tc-99m-sestamibi SPECT vs. O-15 water PET was evaluated on Correlation of regional myocardial flow reserve (MFR) between Tc-99m-sestamibi SPECT and O-15 water PET (R=0.838, p=<0.0001). Regional myocardial flow reserve estimated by dynamic Tc-99m-sestamibi SPECT significantly correlated with O-15 water PET measurements (R=0.838, p<0.0001), demonstrating its utility for estimating the functional severity of coronary lesions.
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