The Value of Tc-99m MIBI Washout Rate in Detection of Ischemia compared with standard Myocardial Perfusion Imaging

Document Type : Original Paper, Cardiology

Authors

1 Oncology and Nuclear Medicine Department, Kasr Al-Aini Hospital, Cairo University, Egypt.

2 Nuclear Medicine, NEMROCK Center, Faculty of Medicine, Cairo University, Cairo, Egypt.

3 NEMROCK Center, Cairo University, Egypt

Abstract

Objective: we aimed to estimate the rate of MIBI washout of myocardium in patients with clinical ischemia as compared to the degree of reversibility between stress and rest studies.
Patients and methods: this prospective study included 50 patients [34 males (60%) & 16 females (40 %)] with mean age 55.3 ± 10.1 years. All patients underwent ECG-gated SPECT Tc-99m MIBI myocardial perfusion imaging. Two days protocol (rest/stress) was used, the rest study was performed at 90 min and delayed images at 4 hours post-injection. While in stress phase images were performed after 30 min. The polar map of perfusion images acquired at stress and rest images at 90 min to detect reversibility. Also, polar map of 90 min was compared with delayed perfusion images at 4 h to calculate washout rate.
Results: there was higher WR in the ischemic myocardial region of LAD (21.18±7.2) compared to the normal one (9.96±2.49), (p < 0.001). Also, in the region of RCA WR was 19.17±3.86 in ischemic wall versus 9.59±1.69 in normal walls (p<0.02) and (LCX) WR was 17.02 ± 2.6 in ischemic wall versus 9.63 ± 1.76 in normal walls (p<0.04). Additionally, the linear correlation of regional WR of each vascular territory was compared with the corresponding degree of reversibility with statistically significant for LAD (0.77), LCx (0.86) and RCA (0.64).
Conclusion: There is higher WR of MIBI in ischemic walls in all vascular territories with significant correlation with its degree of reversibility that may potentiate the results of stress study.

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