FEASIBILITY OF SIMULTANEOUS TC99M SESTAMIBI AND 2D-ECHO CARDIAC IMAGING DURING DOBUTAMINE PHARMACOLOGICAL STRESS - PRELIMINARY-RESULTS IN AFEMALE-POPULATION

Feasibility of simultaneous 2D-Echo and SPECT Tc99m Sestamibi imaging during dobutamine infusion was evaluated in a female population with s uspected coronary artery disease and scheduled for diagnostic coronary angiography. A total of 49 consecutive subjects were studied. Patient s under continuous ECG and 2D-Echo monitoring underwent standard dobut amine infusion at increasing doses to a diagnostic end-point. Tc99m Se stamibi was administered at the peak of the dobutamine effect. With th is approach, 35 patients were identified correctly by 2D-Echo (Sensiti vity = 60.1%; Specificity = 83.3%; Agreement = 71.4%; k = 0.43). Perfu sion imaging with Tc99m Sestamibi resulted in correctly identifying 41 patients (Sensitivity = 83%; Specificity = 84%; Agreement = 83.6%; k = 0.67). Combining information obtained from the two tests resulted in increased specificity (92%) and decreased sensitivity (64%). Simultan eous assessment of perfusion and function with Tc99m Sestamibi and 2D- Echo imaging during dobutamine administration is easily performed with out added risk or discomfort to the patient. Tc99m Sestamibi appeared to be slightly superior to 2D-Echo for the detection of CAD in this po pulation, but the difference does not reach conventional statistical s ignificance. The combined use of the two independent tests did not sub stantially improve the diagnostic accuracy of each method.