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      Thallium-201 for Detection of Myocardial Viability: Comparison of Early Postexercise Reinjection and Imaging with 4 and 18–24 Hours Redistribution Imaging


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          To evaluate the efficacy of an early <sup>201</sup>Tl reinjection and imaging protocol for reducing the need for conventional 4-hour or optimal 24-hour redistribution imaging (RI) and detecting of myocardial viability, we compared the results of early postexercise Tl reinjection and imaging with those of 4- and 24-hour RI in 74 consecutive patients aged 55 ± 9 years (mean ± SD) who were assessed for myocardial ischemia. One millicurie of Tl was injected promptly after completion of the initial postexercise imaging (PEX) and three additional sets of images were acquired 1, 4 and 18–24 h later. A total of 2,368 segments were evaluated. On PEX, 390 (17%) segments showed defects, of which 287 (74%) showed enhanced Tl uptake at 1-hour RI; 89 (23%) did not change and 14 (4%) showed reverse redistribution. Of the 103 persistent defects, only 27 (7%) showed further fill-in of Tl; 62 (16%) segments showed reverse redistribution at 4-hour RI while at 18- to 24-hour RI 17 (4%) and 47 (12%) segments showed further fill-in of Tl and reverse redistribution, respectively. Finally, after analysis of 4- and 18- to 24-hour RI, the diagnosis changed from myocardial necrosis to ischemia in only 2 (3%) patients. In conclusion, these results suggest that by eliminating the need for an additional delayed set of images for detection of myocardial viability, this protocol reduces the total investigation procedure, is more convenient for the patient, increases patient turnover and expedites the decision-making process.

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          Author and article information

          S. Karger AG
          October 1998
          28 October 1998
          : 90
          : 2
          : 137-144
          Department of Medical Physics and Cardiology, Hippokration Hospital, University of Athens, Greece
          6833 Cardiology 1998;90:137–144
          © 1998 S. Karger AG, Basel

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          Page count
          Figures: 6, Tables: 4, References: 32, Pages: 8
          Noninvasive and Diagnostic Cardiology


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