Clinical application of 99Tcm-tetrofosmin in diagnosing patients with coronary heart diesase

Objective To evaluate the diagnostic value of 99Tcm-tetrofosmin(TF) stress-rest MPI in detecting CHD.Methods Eighty patients with suspected CHD who had stress-rest MPI from October 2009 to April 2011 were retrospectively analyzed.Forty underwent 99Tcm-TF (group A) and 40 received ~Tcm-MIBI (group B) stress-rest MPI.Heart/lung (H/L) ratios of these two groups were compared.CAG was performed on group A patients 3 months before and after MPI.Stenosis of more than 50％ in CAG was used as a standard to evaluate the diagnostic efficiency of 99Tcm-TF MPI.Paired t test and x2 test were used to compare the data.Results H/L ratios of rest and stress from 99Tcm-TF images were 6.73 ± 1.21 and 6.94 ± 1.69,while those from 99Tcm-MIBI images were 6.58 ± 1.94 and 6.64 ± 1.81,respectively.There was no difference between 99Tcm-TF and 99Tcm-MIBI imaging in both rest and stress (t =0.41,0.78,both P ＞ 0.05).There was no difference between H/L ratios from stress and rest 99Tcm-TF imaging (t =0.69,P ＞0.05).Twenty-four patients who underwent 99Tcm-TF imaging had abnormal perfusion (60.0％,24/40),including 20 LAD,11 LCX and 14 RCA.Twenty-three among these 40 patients had abnormal CAG results (57.5％,23/40),including 19 LAD,12 LCX,and 11 RCA.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of 99Tcm-TF stress-rest MPI were 87.0％ (20/23),76.5％ (13/17),82.5％ (33/40),83.3％ (20/24) and 81.2％ (13/16),respectively.The sensitivities of 99Tcm-TF stress-rest MPI for detection of LAD,LCX and RCA were 89.5％ (17/19),83.3％ (10/12)and 90.9％ (10/11),respectively,and positive predictive values were 85.0％ (17/20),90.9％ (10/11)and 71.4％ (10/14),respectively.There was no significant difference for sensitivity and positive predictive value of 99Tcm-TF MPI among different vessels (x2 =0.377 and 1.789,both P ＞ 0.05).Conclusions 99Tcm-TF MPI has comparative imaging quality to 99Tcm-MIBI MPI.99Tcm-TF stress-rest MPI is a reliable method for detecting CHD. Key words: Coronary disease; Tomography,emission-computed,single-photon; Technetium; Tetrofosmin