Patients PET Research Articles

Clinical relevance of left ventricular volume assessment by gated myocardial SPET in patients with coronary artery disease.

Coronary artery disease (CAD) is the leading cause of mortality in the Western world. Multiple parameters have been investigated to predict prognosis in CAD patients. The prognostic value of the left ventricular ejection fraction (LVEF) in patients with CAD is well established. More recently, left ventricular (LV) volumes have also shown prognostic value. Due to the favourable imaging characteristics of technetium-99m (high count density), the development of (99m)Tc-labelled myocardial perfusion tracers has made it possible to perform an electrocardiogram-gated acquisition during routine myocardial perfusion imaging. This enables assessment of LVEF and LV volumes during myocardial perfusion scintigraphy. This review considers the possible prognostic abilities of LV volume assessment by gated cardiac SPET.

Early detection of myocardial ischaemia in the emergency department by rest or exercise 99mTc tracer myocardial SPET in patients with chest pain and non-diagnostic ECG

Chest pain (CP) represents a frequent reason for presentation at the emergency department (ED). A large proportion of patients have non-diagnostic ECG on presentation, and in many cases several hours have elapsed since onset of symptoms. Acute rest myocardial scintigraphy (rest SPET) has been shown to have a relevant role in the detection of patients at risk for coronary events, but its sensitivity and negative predictive value are optimal only within the first 3 h following onset of symptoms. In those with delayed presentation, exercise SPET alone, as a screening approach, appears more promising, but its feasibility and diagnostic role in the ED are still unresolved. A total of 231 consecutive patients with a recent-onset (<24 h) first episode of CP had a negative first-line work-up including ECG, troponins, creatine kinase-MB and echocardiography. These patients were considered at low risk for short-term coronary events. Patients were studied with rest SPET if they presented <3 h after onset of CP and exercise SPET if they presented after > or =3 h. The end-points of the study were detection of significant coronary artery disease (CAD) by angiography and major coronary events or cardiac death at 6 months. Eighty patients (35%) underwent rest SPET, while 151 (65%) underwent exercise SPET. Two of the 159 patients with negative SPET had evidence of critical CAD at 6-month follow-up (one patient in the rest SPET group and one in the exercise SPET group; P=NS). Of the 72 patients (31%) with a positive scan, 34 (15%) had documented CAD (16 patients in the rest SPET group and 18 in the exercise SPET group; P=NS). Sensitivity, specificity, accuracy and predictive value were not statistically different between the two groups. In conclusion, the accuracy of exercise SPET in patients with CP and delayed presentation to the ED is comparable to that of validated rest SPET in patients with early presentation. Owing to the high negative predictive value (99%), exercise SPET is especially valuable as a screening tool for the exclusion of CAD in low-risk patients and implementation of early discharge.

1.29 The comparison of post-stress left-ventricular function with resting state in one day stress-rest protocol myocardial perfusion gated SPET in patients with and without significant myocardial ischaemia

1.29 The comparison of post-stress left-ventricular function with resting state in one day stress-rest protocol myocardial perfusion gated SPET in patients with and without significant myocardial ischaemia

16.38 Prognostic value of myocardial perfusion MIBI SPET in patients with prior myocardial infarction

16.38 Prognostic value of myocardial perfusion MIBI SPET in patients with prior myocardial infarction

Tomogammagrafía miocárdica de esfuerzo en los pacientes con miocardiopatía hipertrófica

The aim of this study was to evaluate the diagnostic accuracy of myocardial SPET in patients with hypertrophic cardiomyopathy (HC). One hundred and six consecutive patients (aged 53 +/- 12 years, 50 women, 66 with dynamic obstruction) with an echocardiographic diagnosis of HC were studied with exercise-rest myocardial SPET with 99mTc-tetrofosmin. Forty-six (43%) of these patients had chest pain and in 31 (29%) a coronary angiography was performed. Fifty-six per cent of the patients were treated with beta-blockers and 23% with verapamil. Angina during the exercise test was observed in only 8% of the patients. Perfusion defects were observed in 35% of the patients. Only 8 (26%) out of the 31 patients with angiography had coronary artery disease (stenosis > 50%). When fixed and reversible defects were considered as positive, the sensitivity was 50%, the specificity was 65%, the positive predictive value was 33% and the negative predictive value was 79%. Myocardial perfusion defects can be observed in more than one third of medically treated patients with HC. Only a quarter of catheterized patients, even with chest pain, have associated coronary artery disease. The accuracy of SPET for the diagnosis of coronary artery disease in hypertrophic cardiomyopathy is low. Thus, the value of this technique is limited in these patients.

Clinical application of '231-labelled 15-iodine pentadecanoic acid and SPET in patients with coronary heart disease (CAD)

Clinical application of '231-labelled 15-iodine pentadecanoic acid and SPET in patients with coronary heart disease (CAD)

Significance of paradoxal pattern in technetium-99m-MIBI SPET in patients with coronary artery disease

Significance of paradoxal pattern in technetium-99m-MIBI SPET in patients with coronary artery disease