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Open Access 01-02-2011 | Original Article

Tetrofosmin early time gated post-stress single-photon emission computed tomography imaging: Feasibility and potential benefits

Authors: Laurent Philippe, MD, PhD, Bertrand Mérino, MD, Tanguy Blaire, MD, Alban Bailliez, MD, Danielle Casset-Senon, PhD, Maurice Levy, MD, Arnaud Halley, MD, Guillaume Divry, MD

Published in: Journal of Nuclear Cardiology | Issue 1/2011

Abstract

Background

The purpose of this study is to evaluate the feasibility, the image quality, and the clinical relevance of an early gated post-stress (GPS) single-photon emission computed tomography (SPECT) tetrofosmin (Myoview^™—GE Healthcare) acquisition protocol. Time delay between myocardial technetium-labeled tracer administration and SPECT acquisition is usually about 30 minutes after stress, and 45 to 60 minutes at rest: because of the absence of significant redistribution, perfusion images are related to stress even 30 minutes after stress injection, while function and thickening data obtained with gated acquisition 30 minutes after stress are mainly related to rest conditions.

Methods

194 patients were prospectively included and analyzed, in a multicenter registry. Three gated-SPECT 99^mTc-Tetrofosmin studies were performed per patient: GPS-SPECT, 30 minutes post-stress (GS30), and at rest (GR30).

Results

GPS image quality was excellent/good (93.9%), and similar to GS30 images (96.6%). The presence of adjacent myocardial sub-diaphragmatic activity on GPS images was similar to GS30 images (24% vs 22%), and less frequent than on GR30 images (31%). For perfusion, thickening, and motion scores, there was no significant difference between early and 30 minute post-stress in the global patient population, but significant differences were observed between GPS and GS30 for LVEF (65% ± 15% vs 63% ± 14%). In the ischemic patients, with the stress-rest protocol, the perfusion score was 14.2 on GPS images and 12.4 on GS30 images (P = .002).

Conclusions

Tetrofosmin early GPS-SPECT is feasible without impairment of image quality (better count rate). Ischemic defect size on early post-stress images is slightly more pronounced than at 30 minutes: this could modify therapeutic decision. This technique produces reliable function information during early post-stress period, and might be useful for disclosing transient motion abnormalities.

Matsunari I, Tanishima Y, Taki J, et al. Early and delayed technetium-99m-tetrofosmin myocardial SPECT compared in normal volunteers. J Nucl Med 1996;37:1622-6.PubMed

Jain D, Wackers FJTh, Mattera J, McMahon M, Sinusas AJ, Zaret BL. Biokinetics of technetium-99m-tetrofosmin: Myocardial perfusion imaging agent: Implications for a one-day imaging protocol. J Nucl Med 1993;34:1254-9.PubMed

Hesse B, Tägil K, Cuocolo A, et al. EANM/ESC procedural guidelines for myocardial perfusion imaging in nuclear cardiology. Eur J Nucl Med Mol Imaging 2005;32:855-97.CrossRefPubMed

Giorgetti A, Rossi M, Stanislao M, et al. Feasibility and diagnostic accuracy of a gated SPECT early-imaging protocol: A multicenter study of the myoview imaging olptimization group. J Nucl Med 2007;48:1670-5.CrossRefPubMed

Cerqueira MD, Weissman NJ, Dilsizian V, et al. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. Circulation 2002;105:539-42.CrossRefPubMed

Germano G, Kavanagh PB, Waechter P, et al. A new algorithm for the quantitation of myocardial perfusion SPECT. I: Technical principles and reproducibility. J Nucl Med 2000;41:712-9.PubMed

Slomka PJ, Nishina H, Berman DS, et al. Automated quantification of myocardial perfusion SPECT using simplified normal limits. J Nucl Cardiol 2005;12:66-77.CrossRefPubMed

Sharir T, Germano G, Waechter PB, et al. A new algorithm for the quantification of myocardial perfusion SPECT. II: Validation and diagnostic yield. J Nucl Med 2000;41:720-7.PubMed

Flamen P, Bossuyt A, Franken PR. Technetium-99m-tetrofosmin Dipyridamole-stress myocardial SPECT imaging: Intraindividual comparison with technetium-99m-sestamibi. J Nucl Med 1995;36:2009-15.PubMed

10.

Slomka PJ, Berman DS, Germano G. Quantification of myocardial perfusion. In: Germano G, Berman DS, editors. Clinical gated cardiac SPECT. 2nd ed. Oxford: Blackwell; 2006. p. 69-91.CrossRef

11.

Costo S, Hugentobler A, Parienti J, Bouvard G, Grollier G, Agostini D. Usefulness of early post-stress tetrofosmin gated SPECT in comparison with delayed imaging to detect myocardial perfusion damages. Eur J Nucl Med Mod Imaging 2007;34:S224.

12.

Guernou M, Manrique A, Benhabib H, et al. Evaluation de la faisabilité de la tomographie myocardique précoce au sestamibi synchronisée à l’électrocardigramme. Méd Nucl 2007;31:647-55.CrossRef

13.

Georgoulias P, Demakopoulos N, Kontos A, Xaplanteris P, Xydis K, Fezoylidis I. Early post-stress pulmonary uptake of 99mTc tetrofosmin during exercise (SPECT) myocardial perfusion imaging: Correlation with haemodynamic, perfusion and function parameters. Nucl Med Commun 2006;27:119-26.CrossRefPubMed

14.

Schulz G, Ostwald E, Kaiser HJ, vom Dahl J, Kleinhans E, Buell U. Cardiac stress-rest single-photon emission computed tomography with technetium 99m-labeled tetrofosmin: Influence of washout kinetics on regional myocardial uptake values of the rest study with a 1-day protocol. J Nucl Cardiol 1997;4:298-301.CrossRefPubMed

15.

Sinusas AJ, Shi QX, Saltzberg MT, Vitols P, Jain D, Wackers FJTh, et al. Technetium-99m-tetrofosmin to assess myocardial blood flow: Experimental validation in an intact canine model of ischemia. J Nucl Med 1994;35:664-71.PubMed

16.

Ito Y, Uehara T, Fukuchi K, Tsujimura E, Hasegawa S, Nishimura T. Comparison of dual-isotope acquisition of 201Tl and 99Tc^m-tetrofosmin for the detection of ischaemic heart disease and determination of the optimal imaging time of 99Tc^m-tetrofosmin. Nucl Med Commun 1998;19:119-26.CrossRefPubMed

17.

Shaw LJ, Berman DS, Maron DJ, et al. Optimal medical therapy with or without percutaneous coronary intervention to reduce ischemic burden: Results from the clinical outcomes utilizing revascularization and aggressive drug evaluation (COURAGE) trial nuclear substudy. Circulation 2008;117:1283-91.CrossRefPubMed

18.

Hansen CL, Goldstein RA, Akinboboye OO, et al. ASNC imaging guidelines for nuclear cardiology procedures—myocardial perfusion and function: Single photon emission tomography. J Nucl Cardiol 2007;14e:39-60.CrossRef

19.

Emmett L, Iwanochko RM, Freeman MR, Barolet A, Lee DS, Husain M. Reversible regional wall motion abnormalities on exercise technetium-99m-gated cardiac single photon emission computed tomography predict high-grade angiographic stenoses. J Am Coll Cardiol 2002;39:991-8.CrossRefPubMed

20.

Parker Ward R, Gundeck EL, Lang RM, Spencer KT, Williams KA. Overestimation of postischemic myocardial stunning on gated SPECT imaging: Correlation with echocardiography. J Nucl Cardiol 2006;13:514-20.CrossRefPubMed

21.

Bonow RO. Gated myocardial perfusion imaging for measuring left ventricular function. J Am Coll Cardiol 1997;30:1649-50.CrossRefPubMed

22.

Toba M, Kumita S, Cho K, Ibuki C, Kumazaki T, Takano T. Usefulness of gated myocardial perfusion SPECT imaging soon after exercise to indentify postexercise stunning in patients with single-vessel coronary artery disease. J Nucl Cardiol 2004;11:697-703.CrossRefPubMed

23.

Paul AK, Hasegawa S, Yoshioka J, et al. Characteristics of regional myocardial stunning after exercise in gated myocardial SPECT. J Nucl Cardiol 2002;9:388-94.CrossRefPubMed

24.

Reyes E, Loong CY, Harbinson M, et al. A comparison of Tl-201, Tc-99m sestamibi, and Tc-99m tetrofosmin myocardial perfusion scintigraphy in patients with mild to moderate coronary stenosis. J Nucl Cardiol 2006;13:488-94.CrossRefPubMed

25.

Acampa W, Cuocolo A, Sullo P, et al. Direct comparison of technetium-99m-sestamibi and technetium 99m-tetrofosmin cardiac single photon emission computed tomography in patients with coronary artery disease. J Nucl Cardiol 1998;5:265-74.CrossRefPubMed

26.

Berman DS, Abidov A, Kang X, et al. Prognostic validation of a 17-segment score derived from a 20-segment score for myocardial perfusion SPECT interpretation. J Nucl Cardiol 2004;11:414-23.CrossRefPubMed

Title: Tetrofosmin early time gated post-stress single-photon emission computed tomography imaging: Feasibility and potential benefits
Authors: Laurent Philippe, MD, PhD
Bertrand Mérino, MD
Tanguy Blaire, MD
Alban Bailliez, MD
Danielle Casset-Senon, PhD
Maurice Levy, MD
Arnaud Halley, MD
Guillaume Divry, MD
Publication date: 01-02-2011
Publisher: Springer-Verlag
Published in: Journal of Nuclear Cardiology / Issue 1/2011
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI: https://doi.org/10.1007/s12350-010-9302-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Tetrofosmin early time gated post-stress single-photon emission computed tomography imaging: Feasibility and potential benefits

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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