COMPARISON OF TL-201 SINGLE-PHOTON EMISSION COMPUTED TOMOGRAPHIC SCINTIGRAPHY WITH INTRAVENOUS DIPYRIDAMOLE AND ARM EXERCISE

In patients who cannot perform treadmill exercise, both intravenous di pyridamole and arm exercise have been used with thallium-201 scintigra phy to detect significant coronary artery disease. However, no study h as directly evaluated the results of intravenous dipyridamole and arm exercise thallium scintigraphy as compared with coronary angiography. It was the purpose of this study to compare intravenous: dipyridamole and arm exercise thallium-201 single-photon emission computed tomograp hic (SPECT) scintigraphy for detection of significant coronary artery disease in patients who could not perform treadmill exercise. Data are presented for both intravenous dipyridamole and arm exercise thallium -201 SPECT scintigraphy in 18 men who could net perform treadmill exer cise, and results are compared with those of coronary angiography. Ten of 11 (91%) patients with significant coronary artery disease were id entified correctly, and the results of intravenous dipyridamole and ar m exercise thallium scintigraphy were comparable. In patients without significant coronary artery disease, intravenous dipyridamole thallium images were interpreted correctly. However, initial arm exercise thal lium images demonstrated a fixed inferior wall defect in two of seven patients without significant coronary artery disease. Images in one of these patients could not be retrieved from tape for further analysis. Review of the images in the other patient demonstrated relatively hig h background radioactivity, and when the images were displayed without background subtraction, the inferior wall was correctly interpreted a s normal. We conclude that results of intravenous dipyridamole and arm exercise thallium-201 SPECT scintigraphy are comparable.