thallium-201 and Myocardial-Ischemia

Patients with permanent pacemaker (PPM) implantation may have altered coronary perfusion patterns that may influence the accuracy of myocardial perfusion examination modalities, which was observed in previous studies but with limited statistic power. Our aim was to examine the performance of thallium-201 (TL-201) myocardial perfusion examination in patients with implanted PPM.. Data of consecutive patients from our institution who had coronary angiography examination followed by TL-201 myocardial perfusion examination in pairs within 1 year were collected between January 2010 and December 2016 and were divided into PPM and control groups. Propensity score matching (PSM) was performed to compare the positive predictive value (PPV) of perfusion examinations.. A total of 934 pairs of studies were evaluated, with 81 in the PPM group and 853 controls. The PPV decreased significantly in the PPM group (28.2 vs. 62.9%, P < 0.001). The finding of large (>20%) ischemic areas correlated significantly with all-cause mortality in the control group (OR, 2.34; P = 0.001), but not in the PPM group (OR,1.05; P = 0.943). After PSM, the PPV was still significantly lower in the PPM group than in the non-PPM group (28.6 vs. 66.2%, P < 0.001).. Study results do not support the appropriateness of using TL-201 perfusion examinations for risk stratification in patients with implanted PPM.Video Abstract: http://links.lww.com/NMC/A181.

Topics: Aged; Female; Humans; Male; Middle Aged; Myocardial Ischemia; Myocardial Perfusion Imaging; Pacemaker, Artificial; Thallium Radioisotopes

This study aimed to evaluate the effectiveness of a single computed tomography (CT) based attenuation correction method using thallium-201 chloride (

Topics: Adult; Aged; Aged, 80 and over; Female; Heart Ventricles; Humans; Image Processing, Computer-Assisted; Male; Middle Aged; Myocardial Infarction; Myocardial Ischemia; Myocardial Perfusion Imaging; Retrospective Studies; Thallium; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

The purpose of this study was to assess the prognostic value of ultra-low dose thallium myocardial perfusion imaging. Three hundred and sixty-six patients (245 men) underwent ultra-low dose stress-redistribution imaging on CZT SPECT camera GE Discovery NM 530c. The stress test was performed by bicycle ergometry or regadenoson injection. The activity of 0.5 MBq (0.014 mCi) Tl-201 chloride per kilogram of body weight was administered. The stress images were acquired immediately and redistribution images were taken after 3 h. Patient follow-up was focused on combined end-point (death, myocardial infarction, unstable angina, revascularization and hospitalization for heart failure). Data analysis was performed from hospital database, with a mean period 23 months. Patients with revascularization within 1 month after SPECT was excluded as revascularization for diagnosis. Ischaemia on SPECT was found in 72 patients, 294 patients were without ischaemia. In patients with ischaemia there were 21 (29.2%) subjects with cardiac events, and 23 (7.9%) in patients without ischaemia (HR 4.15, 95% CI 2.30-7.51, p < 0.0001). Ultra-low dose thallium perfusion imaging using CZT camera provides very good prognostic results in assessment of myocardial ischaemia.

Topics: Aged; Cadmium; Coronary Circulation; Disease Progression; Equipment Design; Exercise Test; Female; Gamma Cameras; Humans; Male; Middle Aged; Myocardial Ischemia; Myocardial Perfusion Imaging; Pilot Projects; Predictive Value of Tests; Prognosis; Purines; Pyrazoles; Radiation Dosage; Radiation Exposure; Radiopharmaceuticals; Reproducibility of Results; Tellurium; Thallium Radioisotopes; Time Factors; Tomography, Emission-Computed, Single-Photon; Vasodilator Agents; Zinc