Exercise Tl-201/rest Tc-99(m)-tetrofosmin myocardial perfusion imaging: A convenient protocol for the assessment of coronary disease

Standard exercise thallium-201 (Tl-201)-redistribution protocols for the detection of coronary artery disease take about 4 h to complete. This is inconvenient for both patients and staff. The higher energy technetium-99m (Tc-99(m)) emissions permit immediate imaging after Tl-201 with minimal crosstalk. This study assessed exercise gated planar Tl-201 scintigraphy (55 MBq) followed by rest gated planar Tc-99(m)-tetrofosmin scintigraphy (250 MBq) in 32 patients. The results showed a high sensitivity for the detection of coronary disease (100%) in this highly selective group of patients. In order to diagnose myocardial infarction accurately it was necessary to view the gated Tl-201 images and assess regional wall motion in a defect zone. This gave a specificity of 88% and a sensitivity of 71% for the prediction of myocardial infarction on the angiographic ventriculogram. Stress Tl-201/rest Tc-99(m)-tetrofosmin is a useful short protocol for patients unable to complete the full 4-h exercise Tl-201-redistribution study.