The Canadian exercise technetium 99m-labeled teboroxime single-photon emission computed tomographic study

Robert J. Burns; Sian Iles; Anthony Y. Fung; Linda M. Wright; Luc Daigneault

doi:10.1016/S1071-3581(95)80022-0

The Canadian exercise technetium 99m-labeled teboroxime single-photon emission computed tomographic study

Robert J. Burns, Sian Iles, Anthony Y. Fung, Linda M. Wright, Luc Daigneault

Research output: Contribution to journal › Article › peer-review

5 Citations (Scopus)

Abstract

Background: ^99mTc-labeled teboroxime undergoes rapid washout from the myocardium. For this reason, its use has been favored in conjunction with pharmacologic stress, which enables patient positioning before tracer administration, and multidetector single-photon emission computed tomography (SPECT), which enables rapid acquisition. We evaluated treadmill exercise ^99mTc-labeled teboroxime SPECT with single-detector systems for the detection of coronary artery disease. Methods and Results: Treadmill exercise ^99mTc-labeled teboroxime SPECT was compared with analogous ²⁰¹TI-labeled imaging in 108 patients. Teboroxime was injected first during exercise and then at rest. Nine myocardial segments per study were scored with respect to uptake of activity during stress and at rest (teboroxime) or after redistribution (²⁰¹TI). Perfusion was defined as normal, reversible, or fixed. Overall agreement of ²⁰¹TI versus teboroxime segmental perfusion (normal vs abnormal) was 772/961 (80.3%; \gc² = 258; p<0.001; κ=0.51) or (normal vs reversible vs fixed) 711/961 (74.0%; \gc² = 296; p<0.001; κ=0.42). Fifty-six patients also underwent selective coronary angiography. Stenoses greater than 50% of lumenal diameter were drawn on individualized coronary artery diagrams applied to polar plots of scintigraphic segments to compare detection of coronary artery disease. Sensitivity and accuracy of teboroxime were 0.80 and 0.79, respectively, compared with 0.84 and 0.82 for ²⁰¹TI (difference not significant). Mean imaging procedure time was 113.6 minutes for teboroxime and 240.5 minutes for ²⁰¹TI (p<0.001). Conclusions: ^99mTc-labeled teboroxime is amenable to simple modifications of routine treadmill exercise SPECT myocardial perfusion imaging protocols with widely available single-detector SPECT systems. This modality provides results similar to those of exercise ²⁰¹TI SPECT and is significantly faster.

Original language	English
Pages (from-to)	117-125
Number of pages	9
Journal	Journal of Nuclear Cardiology
Volume	2
Issue number	2
DOIs	https://doi.org/10.1016/S1071-3581(95)80022-0
Publication status	Published - Mar 1995
Externally published	Yes

Bibliographical note

Funding Information:
From the Nuclear Cardiology Laboratory, Division of Cardiology, Department of Medicine, The Toronto Hospital and the Centre for Cardiovascular Research, University of Toronto, Toronto, Ontario, the Department of Nuclear Medicine, Victoria General Hospital, Halifax, Nova Scotia, the DMsion of Cardiology, Department of Medicine, Vancouver General Hospital, Van-couver, British Columbia, and Bristol-Myers Squibb Pharma-ceutical Group, Montreal, Quebec. Supported by a grant from Squibb Diagnostics Canada. Submitted for publication Sept. 2, 1994; revision accepted Nov. 17, 1994. Reprint requests: Robert J. Bums, MD, EW5-552, The Toronto Hospital, 399 Bathurst St., Toronto, Ontario, Canada, M5T 2S8. *Complete listing in Appendix. Copyright 9 1995 by American Society of Nuclear Cardiology. 1071-3581/95/$3.00 + 0 43/1/62105

ASJC Scopus Subject Areas

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

PubMed: MeSH publication types

Journal Article
Research Support, Non-U.S. Gov't

Access to Document

10.1016/S1071-3581(95)80022-0

Cite this

@article{b63e079b13b64780b4116ae9923de9d2,

title = "The Canadian exercise technetium 99m-labeled teboroxime single-photon emission computed tomographic study",

abstract = "Background: 99mTc-labeled teboroxime undergoes rapid washout from the myocardium. For this reason, its use has been favored in conjunction with pharmacologic stress, which enables patient positioning before tracer administration, and multidetector single-photon emission computed tomography (SPECT), which enables rapid acquisition. We evaluated treadmill exercise 99mTc-labeled teboroxime SPECT with single-detector systems for the detection of coronary artery disease. Methods and Results: Treadmill exercise 99mTc-labeled teboroxime SPECT was compared with analogous 201TI-labeled imaging in 108 patients. Teboroxime was injected first during exercise and then at rest. Nine myocardial segments per study were scored with respect to uptake of activity during stress and at rest (teboroxime) or after redistribution (201TI). Perfusion was defined as normal, reversible, or fixed. Overall agreement of 201TI versus teboroxime segmental perfusion (normal vs abnormal) was 772/961 (80.3%; \gc2 = 258; p<0.001; κ=0.51) or (normal vs reversible vs fixed) 711/961 (74.0%; \gc2 = 296; p<0.001; κ=0.42). Fifty-six patients also underwent selective coronary angiography. Stenoses greater than 50% of lumenal diameter were drawn on individualized coronary artery diagrams applied to polar plots of scintigraphic segments to compare detection of coronary artery disease. Sensitivity and accuracy of teboroxime were 0.80 and 0.79, respectively, compared with 0.84 and 0.82 for 201TI (difference not significant). Mean imaging procedure time was 113.6 minutes for teboroxime and 240.5 minutes for 201TI (p<0.001). Conclusions: 99mTc-labeled teboroxime is amenable to simple modifications of routine treadmill exercise SPECT myocardial perfusion imaging protocols with widely available single-detector SPECT systems. This modality provides results similar to those of exercise 201TI SPECT and is significantly faster.",

author = "Burns, {Robert J.} and Sian Iles and Fung, {Anthony Y.} and Wright, {Linda M.} and Luc Daigneault",

note = "Funding Information: From the Nuclear Cardiology Laboratory, Division of Cardiology, Department of Medicine, The Toronto Hospital and the Centre for Cardiovascular Research, University of Toronto, Toronto, Ontario, the Department of Nuclear Medicine, Victoria General Hospital, Halifax, Nova Scotia, the DMsion of Cardiology, Department of Medicine, Vancouver General Hospital, Van-couver, British Columbia, and Bristol-Myers Squibb Pharma-ceutical Group, Montreal, Quebec. Supported by a grant from Squibb Diagnostics Canada. Submitted for publication Sept. 2, 1994; revision accepted Nov. 17, 1994. Reprint requests: Robert J. Bums, MD, EW5-552, The Toronto Hospital, 399 Bathurst St., Toronto, Ontario, Canada, M5T 2S8. *Complete listing in Appendix. Copyright 9 1995 by American Society of Nuclear Cardiology. 1071-3581/95/$3.00 + 0 43/1/62105",

year = "1995",

month = mar,

doi = "10.1016/S1071-3581(95)80022-0",

language = "English",

volume = "2",

pages = "117--125",

journal = "Journal of Nuclear Cardiology",

issn = "1071-3581",

publisher = "Springer New York",

number = "2",

}

TY - JOUR

T1 - The Canadian exercise technetium 99m-labeled teboroxime single-photon emission computed tomographic study

AU - Burns, Robert J.

AU - Iles, Sian

AU - Fung, Anthony Y.

AU - Wright, Linda M.

AU - Daigneault, Luc

N1 - Funding Information: From the Nuclear Cardiology Laboratory, Division of Cardiology, Department of Medicine, The Toronto Hospital and the Centre for Cardiovascular Research, University of Toronto, Toronto, Ontario, the Department of Nuclear Medicine, Victoria General Hospital, Halifax, Nova Scotia, the DMsion of Cardiology, Department of Medicine, Vancouver General Hospital, Van-couver, British Columbia, and Bristol-Myers Squibb Pharma-ceutical Group, Montreal, Quebec. Supported by a grant from Squibb Diagnostics Canada. Submitted for publication Sept. 2, 1994; revision accepted Nov. 17, 1994. Reprint requests: Robert J. Bums, MD, EW5-552, The Toronto Hospital, 399 Bathurst St., Toronto, Ontario, Canada, M5T 2S8. *Complete listing in Appendix. Copyright 9 1995 by American Society of Nuclear Cardiology. 1071-3581/95/$3.00 + 0 43/1/62105

PY - 1995/3

Y1 - 1995/3

N2 - Background: 99mTc-labeled teboroxime undergoes rapid washout from the myocardium. For this reason, its use has been favored in conjunction with pharmacologic stress, which enables patient positioning before tracer administration, and multidetector single-photon emission computed tomography (SPECT), which enables rapid acquisition. We evaluated treadmill exercise 99mTc-labeled teboroxime SPECT with single-detector systems for the detection of coronary artery disease. Methods and Results: Treadmill exercise 99mTc-labeled teboroxime SPECT was compared with analogous 201TI-labeled imaging in 108 patients. Teboroxime was injected first during exercise and then at rest. Nine myocardial segments per study were scored with respect to uptake of activity during stress and at rest (teboroxime) or after redistribution (201TI). Perfusion was defined as normal, reversible, or fixed. Overall agreement of 201TI versus teboroxime segmental perfusion (normal vs abnormal) was 772/961 (80.3%; \gc2 = 258; p<0.001; κ=0.51) or (normal vs reversible vs fixed) 711/961 (74.0%; \gc2 = 296; p<0.001; κ=0.42). Fifty-six patients also underwent selective coronary angiography. Stenoses greater than 50% of lumenal diameter were drawn on individualized coronary artery diagrams applied to polar plots of scintigraphic segments to compare detection of coronary artery disease. Sensitivity and accuracy of teboroxime were 0.80 and 0.79, respectively, compared with 0.84 and 0.82 for 201TI (difference not significant). Mean imaging procedure time was 113.6 minutes for teboroxime and 240.5 minutes for 201TI (p<0.001). Conclusions: 99mTc-labeled teboroxime is amenable to simple modifications of routine treadmill exercise SPECT myocardial perfusion imaging protocols with widely available single-detector SPECT systems. This modality provides results similar to those of exercise 201TI SPECT and is significantly faster.

AB - Background: 99mTc-labeled teboroxime undergoes rapid washout from the myocardium. For this reason, its use has been favored in conjunction with pharmacologic stress, which enables patient positioning before tracer administration, and multidetector single-photon emission computed tomography (SPECT), which enables rapid acquisition. We evaluated treadmill exercise 99mTc-labeled teboroxime SPECT with single-detector systems for the detection of coronary artery disease. Methods and Results: Treadmill exercise 99mTc-labeled teboroxime SPECT was compared with analogous 201TI-labeled imaging in 108 patients. Teboroxime was injected first during exercise and then at rest. Nine myocardial segments per study were scored with respect to uptake of activity during stress and at rest (teboroxime) or after redistribution (201TI). Perfusion was defined as normal, reversible, or fixed. Overall agreement of 201TI versus teboroxime segmental perfusion (normal vs abnormal) was 772/961 (80.3%; \gc2 = 258; p<0.001; κ=0.51) or (normal vs reversible vs fixed) 711/961 (74.0%; \gc2 = 296; p<0.001; κ=0.42). Fifty-six patients also underwent selective coronary angiography. Stenoses greater than 50% of lumenal diameter were drawn on individualized coronary artery diagrams applied to polar plots of scintigraphic segments to compare detection of coronary artery disease. Sensitivity and accuracy of teboroxime were 0.80 and 0.79, respectively, compared with 0.84 and 0.82 for 201TI (difference not significant). Mean imaging procedure time was 113.6 minutes for teboroxime and 240.5 minutes for 201TI (p<0.001). Conclusions: 99mTc-labeled teboroxime is amenable to simple modifications of routine treadmill exercise SPECT myocardial perfusion imaging protocols with widely available single-detector SPECT systems. This modality provides results similar to those of exercise 201TI SPECT and is significantly faster.

UR - http://www.scopus.com/inward/record.url?scp=0028914548&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028914548&partnerID=8YFLogxK

U2 - 10.1016/S1071-3581(95)80022-0

DO - 10.1016/S1071-3581(95)80022-0

M3 - Article

C2 - 9420776

AN - SCOPUS:0028914548

SN - 1071-3581

VL - 2

SP - 117

EP - 125

JO - Journal of Nuclear Cardiology

JF - Journal of Nuclear Cardiology

IS - 2

ER -

The Canadian exercise technetium 99m-labeled teboroxime single-photon emission computed tomographic study

Abstract

Bibliographical note

ASJC Scopus Subject Areas

PubMed: MeSH publication types

Access to Document

Other files and links

Fingerprint

Cite this