PATTERNS OF USE AND CLINICAL UTILITY OF EXERCISE TL-201 SINGLE-PHOTONEMISSION-COMPUTED TOMOGRAPHY IN A COMMUNITY-HOSPITAL

Single photon emission computed tomographic (SPECT) imaging with thall ium-201 was evaluated in 492 consecutive, unselected patients to ascer tain the patterns of use and additive value to the exercise electrocar diogram in the diagnosis of myocardial ischemia in a community hospita l setting, Myocardial perfusion images were interpreted by a single ob server employing visual and confirmatory quantitative analysis. The ma jority of patients (69%) were studied to evaluate the functional conse quences of known coronary artery disease and not primarily to aid in d iagnosis, Relationships among exercise electrocardiograms, SPECT infor mation and coronary angiography were analyzed in 303 patients. The sen sitivity was 92% and improved to 96% when multivessel disease was pres ent, Overall, the positive predictive value of tomographic imaging in the detection of coronary disease was 94%, These findings demonstrate the changing pattern of use of myocardial perfusion imaging and confir m the value and applicability of this technique in routine clinical pr actice.