TL-201 MYOCARDIAL PERFUSION SCINTIGRAPHY - RESULTS OF STANDARD AND MULTI-PINHOLE TOMOGRAPHIC TECHNIQUES

A new method of cardiac tomography was developed using a seven pinhole (5.5 mm diameter) collimator, a standard 37.5 cm diameter crystal Anger camera and a digital computer. Twelve planes spaced an average of 1.0 cm apart are reconstructed through use of a computer algorithm from a single stationary data acquisition. A comparison of the tomographic technique and standard (parallel-hole collimatlon) scintigraphy was performed using 65 patients (Group I), 23 without and 42 with angiographically demonstrated coronary arterial stenosis (greater than 70 percent luminal narrowing) who were undergoing stress thallium-201 imaging. An additional 7 normal subjects and 32 patients with coronary artery disease (Group II) underwent both tomographic imaging during stress and redistribution or rest. The tomographic images and standard anterior and left anterior oblique scintigrams were interpreted with use of a computerized program that determines maximal circumferential cardiac wall count densities and compares these profiles with normal limits obtained from the initially tested 23 subjects without coronary disease in Group I. Of these 23 persons, one had an abnormal standard scintigram and one an abnormal tomogram. Of the 42 patients with coronary disease in Group I, 31 had an abnormal standard scintigram and 40 an abnormal tomogram (P < 0.05). Of the 39 patients (Group II) undergoing tomographic stress and redistribution or rest imaging, none of the 7 normal subjects and 31 of the 32 (97 percent) with coronary artery disease had quantitatively abnormal stress images or greater than 20 percent segmental redistribution. These results suggest that this tomographic technique is both highly sensitive to and specific for the presence of coronary artery disease using stress thallium-201 imaging. © 1979.