THE 24-HOUR TL-201 IMAGE IN DUAL-ISOTOPE MYOCARDIAL PERFUSION SCINTIGRAPHY - CLINICAL UTILITY AND PROGNOSTIC-SIGNIFICANCE

This study assessed the effect on clinical decision making and the pos sible prognostic significance of the 24-hour TI-201 image in patients undergoing TI-201-MIBI dual-isotope myocardial scintigraphy. The recor ds of all patients who underwent 24-hour TI-201 imaging as part of the ir myocardial perfusion study from 1994 to 1996 were reviewed. Follow- up evaluations were obtained from the referring physician or by direct patient contact. Fifty-six patients underwent a total of 57 studies; four patients were lost to follow-up. Of the 53 studies evaluated, 29 showed no change between the standard rest images and the 24-hour imag es; these patients were reported to have myocardial scar. Of these 29 patients, 25 were treated medically without further evaluation; 24 of these 25 patients remained stable. Four of the 29 patients had further evaluation; 2 patients had coronary artery bypass graft, 1 had a sten t placed, and 1 remained stable. Twenty-four patients showed definite improvement or normalization of their study results by 24 hours; they were reported as ischemic. Of these 24 patients, 11 were treated medic ally without further evaluation; 9 remained stable, whereas 2 had adve rse events. The remaining 13 patients required further evaluation; 4 r emained stable, whereas 9 had adverse events (4 = increasing angina; 1 = stent; 1 = rotoblator; 2 = percutaneous transluminal coronary angio plasty; 1 = death). Twenty-four-hour imaging contributes to clinical d ecision making and may identify a subset of patients at risk for subse quent complications.