TECHNETIUM-99M MIBI GATED MYOCARDIAL PERFUSION SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY IMAGING – VALIDATION OF STRESS ONLY PROTOCOL

  • Zaigham Salim Dar Armed Forces Institute of Cardiology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Mehdi Raza Armed Forces Institute of Cardiology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Muhammad Atif Armed Forces Institute of Cardiology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Aown Raza Bukhari Armed Forces Institute of Cardiology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Keywords: Myocardial perfusion imaging, Rest/stress imaging, 99mTc-MIBI

Abstract

Objective: To validate ‘stress only’ protocol against ‘rest stress protocol in normal and essentially normal cases undergoing Tc99m MIBI gated myocardial perfusion Single Photon Emission Computed Tomography imaging.

Study Design: A retrospective observational study.

Place and Duration of Study: Department of Nuclear Cardiology, Armed Forces Institute of Cardiology/National Institute of Heart Disease, Rawalpindi, Pakistan, from Jul to Sep 2019.

Methodology: 136 cases were included. Patients underwent Tc-99m gated Single Photon Emission Computed Tomography MPI using a single day, rest/stress protocol. The rest study was performed first with 8-10 mCi Tc-99m MIBI followed by stress study, 3 hours later with 3 times the rest dose. The most common stress technique was pharmacological stress and bicycle ergometer exercise with 0.14 mg/kg/min adenosine infusion. Few patients underwent physical stress using Bruce protocol, achieving a minimum of 85% of the target heart rate. Mages–stress followed by rest–were evaluated by two experienced nuclear cardiologists (blinded to the MPI reports) and interpreted as ‘normal’ or ‘essentially normal’.

Results: Evaluation of stress-only and rest-stress Single Photon Emission Computed Tomography myocardial images yielded a concordance rate of 84.56% with Cohen’s kappa coefficient of 0.69.

Conclusion: Substantial agreement and good concordance were found in normal and essentially normal ‘stress only’ and ‘rest stress protocols.

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Published
2021-10-31
How to Cite
Dar, Z., Raza, M., Atif, M., & Bukhari, A. (2021). TECHNETIUM-99M MIBI GATED MYOCARDIAL PERFUSION SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY IMAGING – VALIDATION OF STRESS ONLY PROTOCOL. PAFMJ, 71(5), 1741-45. https://doi.org/10.51253/pafmj.v71i5.5391
Section
Original Articles

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