Segmental analysis of SPECT99mTc-methoxy isobutyl isonitrile and201Tl myocardial imaging in ischaemic heart disease

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Abstract
To study the potential usefulness of99mTc-methoxy isobutyl isonitrile (99mTc-MIBI) as a substitute for201Tl in assessing patients with ischaemic heart disease, 24 patients underwent 1 day rest and exercise99mTc-MIBI single photon emission computerised topography (SPECT) 1 week after SPECT exercise201Tl. All patients were catheterized within 1 month after myocardial imaging. In 17 patients, resting first pass radionuclide angiography (FPRNA) was performed with99mTc-MIBI. The heart to lung ratio for99mTc-MIBI and201Tl was calculated both at rest and exercise. The segmental analysis for myocardial perfusion reveals that 87/96 segments (91 %) were correctly classified by SPECT201Tl and 84/96 segments (88%) were correctly classified by99mTc-MIBI. A significant correlation was present between LVEF measured by99mTc-MIBI FPRNA and contrast ventriculography (r = 0.85,P < 0.0001). The heart to lung ratio both at rest and exercise for99mTc-MIBI is significantly higher than201Tl (P < 0.01 and 99mTc-MIBI is a promising agent for simultaneous evaluation of myocardial perfusion and cardiac function.