Diagnostic Value of Dipyridamole Tc-99m Tetrofosmin SPECT for Detection of Coronary Artery Disease

Abstract

Background and Objects:Tc-99m tetrofomsin is a recently developed myocardial perfusion agent. We examined the diagnostic accuracy of dipyridamole Tc-99m tetrofosmin SPECT. Materials and Method:61 patients underwent one-day rest/dipyridamole Tc-99m tetrofosmin SPECT. 26 patients had history of myocardial infarction. Coronary angiography, performed within 1 week after SPECT study, revealed normal coronary arteries or insignificant coronary artery stenosis in 19 and 22 patients (when considering ≥50% or ≥70% reduction of luminal diameter as significant stenosis. Results:Number of male was 39 (63.9% and mean age was 59(range 32-84). The diagnostic accuracy of dipyridamole Tc-99m tetrofosmin SPECT for detection of coronary artery disease (≥50% and ≥70% coronary artery stenosis, respectively was as follows:sensitivity 90.5%, 90.0%, specificity 73.7%, 66.7%, positive predictive value 88.4%, 83.7%, negative predictive value 77.8%, 77.8% and predictive accuracy was 85.2%, 81.9% respectively. The overall sensitivity and specificity of dipyridamole Tc-99m tetrofosmin SPECT for detection of individual coronary stenosis(≥50% and ≥70% coronary stenosis by coronary angiography were 64.6%, 64.1% and 86.4%, 85.7% respectively. In patients without myocardial infarction, sensitivity 76.5%, specificity 76.5%, positive predictive value 83.3%, negative predictive value 76.5% and predictive accuracy was 80.0%. Conclusion: One-day rest/stress dipyridamole Tc-99m tetrofosmin myocardial SPECT is a useful noninvasive method for detection of coronary artery disease. (Korean Circulation J 1998;28(6 :923-930