HEAD-TO-HEAD COMPARISON BETWEEN TECHNETIUM-99M-SESTAMIBI AND TL-201 TOMOGRAPHIC IMAGING FOR THE DETECTION OF CORONARY-ARTERY DISEASE USING COMBINED DIPYRIDAMOLE-EXERCISE STRESS

Aim: The purpose of this study was a head-to-head comparison of tomogr aphic imaging (SPECT) with technetium-99m (Tc-99m)-sestamibi and thall ium-201 (Tl-201) using dipyridamole-low-level bicycle exercise stress for the assessment of coronary artery disease. Methods: We studied 38 consecutive patients referred for the evaluation of chest pain who had undergone coronary angiography. The patients were randomly allocated to Tc-99m-sestamibi SPECT followed by Tl-201 SPECT or vice versa. The accuracy of both tracers in detecting significant coronary artery dise ase (>50% luminal stenosis) was 87% (95% confidence interval 72-96%). Only two patients were classified differently by the two methods. Resu lts: On a segmental basis, good agreement was found between Tc-99m-ses tamibi and Tl-201 for both the localization and the nature of perfusio n defects (reversible or persistent) identified (Cohen's kappa=0.67). Conclusion: No clinically relevant differences in diagnostic accuracy were demonstrated between Tc-99m-sestamibi and Tl-201 SPECT using comb ined dipyridamole-exercise stress for the evaluation of coronary arter y disease.