International Conference on Integrated Medical Imaging in Cardiovascular Diseases (IMIC 2016)

Comparison in 30 Patients Between Risordan Test and Thallium-201 Chloride Rest Myocardial Scintigraphy in Viability After Myocardial Infarct

Not scheduled

15m

IAEA Headquarters, Vienna

poster Use of hybrid diagnostic imaging in cardiology

Speaker

Dr ZOHIR BOUGUERRI (Nuclear Medicine Department Central Hospital of Army .KOUBA-ALGIERS-ALGERIA)

Description

Background: This study aimed to test whether sublingual administration of Nitrate (Risordan) could improve the capability of Tc-99m-MIBI to detect viable myocardium by contribution to the baseline examination (Tc-99m-MIBI single) and to compare it with the thallium-201(Tl-201) rest-redistribution protocol. Methods: - The study is a comparison of diagnostic procedures performed over a period of 3 months (first quarter 2016). - Thirty patients (23 men and 7 women with sex ratio 3.2; mean age 61.63 ± 3.0 years) with previous history of myocardial infarction were included in the study. - All patients underwent baseline rest, as well as Risordan 99mTc-MIBI myocardial perfusion imaging and rest- redistribution Tl-201 imaging (3 day protocol). - The data were reconstructed in transaxial slices with iterative algorithm (Astonish) and then reoriented into short, vertical long and horizontal long axis slices. - Scintigraphic analysis was performed using quantitative perfusion SPECT (QPS), providing the percentage radiotracer uptake and defect severity in a 17-segment model. - The segments with tracer activity of more than 50% as compared to maximum, or reversibility ≥ 10% were considered as viable. - The images were interpreted by two independent observers. - The computer operating software is made on EpiInfo 6.04Dfr and Epidataanalysis V2.2.2.182 (comparison of two samples matched sets). Results: - A total of 510 myocardial segments were evaluated by quantitative analysis. - In the baseline study with 99mTc-MIBI, 357/510 (70%) were viable segments and these were increased to 393/510 (77%) in the Risordan/MIBI study (p=0.001 vs. baseline). A total of 19 (63.33%) out of 30 patients showed an improvement of viable myocardium. - The concordance for viable and non-viable segments detection between Risordan/MIBI and rest-redistribution TI-201 imaging was found in 487 out of 510 segments (95.49%). 4% (21/510) of segments that were non-viable on Risordan/MIBI studies were viable on 201 Tl studies, whereas 0.3% (2/510) were non-viable on 201 Tl studies were viable on Risordan/MIBI studies (p <0.001). Conclusion: Our data suggest that the use of Risordan/MIBI protocol improves detection of viable segments and achieves results very close to those from standard Tl-201 rest- redistribution protocol and therefore might be considered as a potential alternative to the Tl201, which is more expensive, less available and irradiating.