Technetium 99m furifosmin regional myocardial uptake in patients with previous myocardial infarction: Relation to thallium-201 activity and left ventricular function

Background. This study was designed to compare the results of rest-redistri bution thallium-201 imaging with those of rest technetium 99m furifosmin si ngle photon emission computed tomography in the same patients with chronic ischemic left ventricular (LV) dysfunction, Methods. Twenty-one patients (mean age 62 +/- 9 years) with chronic myocard ial infarction and LV dysfunction (mean LV ejection fraction 34% +/- 8%) un derwent rest-redistribution thallium imaging and resting furifosmin single photon emission computed tomography on the same day. In each patient, regio nal thallium and furifosmin activity was quantitatively measured in 13 myoc ardial segments, Regional LV function was assessed in corresponding segment s by echocardiography, Results, At thallium imaging, 91 (33%) segments had normal uptake, 16 (6%) showed reversible defects, and the remaining 166 (61%) irreversible defects . Of these 166 irreversible defects, 74 (45%) had moderate (greater than or equal to 58% of peak activity) and 92 (55%) severe (<58% of peak activity) reduction of thallium uptake. Regional furifosmin uptake was significantly related to both rest (r = 0.87, P < .0001) and redistribution (r = 0.90, P < .0001) thallium activity. Agreement in the evaluation of regional perfus ion status between thallium and furifosmin imaging was observed in 70% of t he 84 hypokinetic segments (kappa = 0.54) and in 76% of the 78 akinetic or dyskinetic segments (kappa = 0.60), Concordance in the detection of myocard ial viability between thallium and furifosmin imaging was observed in 69 (8 2%) of hypokinetic regions (kappa = 0.60) and in 65 (83%) of akinetic or dy skinetic regions (kappa = 0.67). Conclusions, These results suggest that in patients with chronic coronary a rtery disease and LV dysfunction, quantitative rest-redistribution thallium scintigraphy and furifosmin tomography at rest provide similar results in the evaluation of perfusion status and in the detection of myocardial viabi lity.