S. Bendel et al., Similar effect of revascularization on technetium-99m sestamibi and 15-(p-iodophenyl)pentadecanoic acid uptake in myocardial infarction patients, EUR J NUCL, 26(10), 1999, pp. 1304-1309
Citations number
27
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
To study its usefulness as a tracer for assessment of the perfusion and via
bility of myocardium, 15(p-iodophenyl)pentadecanoic acid (IPPA) was compare
d with technetium-99m sestamibi (MIBI). Dual-tracer single-photon emission
tomography rest imaging was performed no more than 2 months before and 3 mo
nths after coronary artery bypass grafting in 28 patients with previous ant
erior (n=13) or inferior (n=55 infarction, The size of MIBI and IPPA defect
s decreased from 14%+/-12% and 13%+/-9% to 10%+/-11% and 9%+/-7%, respectiv
ely (P<0.001 for both), The MIBI uptake increased in the infarct zones fi o
m 35%+/-11% to 43%+/-8% (P<0.001), and in the peri-infarct zones from 50%+/
-11% to 55%+/-10% (P<0.05). The IPPA uptake increased in the infarct zones
from 37%+11% to 14%+/-13% (P<0.001), and in the peri-infarct zones from 51%
+/-11% to 57%+/-12% (P<0.05). In nine patients with improved regional echoc
ardiographic wall motion score after bypass surgery, the pre-operative upta
ke values of both MIBI and IPPA in the infarct and peri-infarct zones were
on average slightly but not significantly higher than in 19 patients with n
o observed improvement in regional wall motion score. In patients with impr
oved regional wall motion, the MIBI scans and the IPPA scans showed (non-si
gnificant) decreases in defect size and increases in infarct and peri-infar
ct zone uptake after bypass surgery. Similar tin some cases significant) ch
anges were observed in the patients without improvement in wall motion. Thu
s IPPA and MIBI provided similar information about perfusion and viability
in pre- and postoperative evaluation of patients with clinically evident my
ocardial infarction and with normal global ejection fraction. Regardless of
the tracer used, the resolution capability of the dual-tracer method with
a rest imaging protocol was not sufficient to differentiate viable from non
viable infarction defects in unselected individual patients with a normal e
jection fraction.