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  • Title: Regional concordance and discordance between rest thallium 201 and sestamibi imaging for assessing tissue viability: comparison with postrevascularization functional recovery.
    Author: Marzullo P, Sambuceti G, Parodi O, Gimelli A, Picano E, Giorgetti A, L'Abbate A.
    Journal: J Nucl Cardiol; 1995; 2(4):309-16. PubMed ID: 9420805.
    Abstract:
    BACKGROUND: Whether the combined analysis of rest 201Tl and sestamibi uptake provides additional information regarding myocardial viability in patients with coronary artery disease is still to be investigated. METHODS AND RESULTS: To this aim we studied 22 patients with previous myocardial infarction and regional ventricular dysfunction by quantitative rest sestamibi and 201Tl scintigraphy. All patients underwent revascularization, and echocardiography was repeated 11 +/- 2 weeks later. Concordant results were obtained in 80 of 105 dyssynergic segments. Fifty-one segments showed normal and 29 abnormal activity. Follow-up echocardiography showed increased wall motion contractility in 76% of segments with maintained 201Tl and sestamibi uptake and in only 17% of segments characterized by subthreshold activities. Twenty-five segments, or 24%, showed sestamibi/201Tl mismatch. Eleven of 12 segments with normal sestamibi/abnormal 201Tl activity did not improve after revascularization, whereas 11 of 13 segments with abnormal sestamibi but normal 201Tl showed postoperative improvement of regional wall motion. CONCLUSIONS: In patients with previous myocardial infarction, sestamibi and 201Tl showed concordant results in most segments. However, in segments with mismatch a maintained sestamibi uptake was a poor indicator of tissue viability, whereas significant 201Tl uptake reflected tissue viability in most segments.
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