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The Quarterly Journal of Nuclear Medicine and Molecular imaging 2009 December;53(6):671-7

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

Decreased [99mTc]Sestamibi uptake with dobutamine versus dipyridamole stress

Sciagrà R., Zoccarato O., Bisi G., Pupi A.

1 Nuclear Medicine Unit, Department of Clinical Physiopathology, University of Florence; Florence, Italy; 2 Nuclear Medicine Laboratory, Salvatore Maugeri” Foundation IRCCS, Veruno, Novara, Italy; 3 Nuclear Medicine, University of Turin, Turin, Italy


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AIM: Animal studies suggest an interference of dobutamine on [99mTc]sestamibi uptake. In this study dobutamine was compared to dipyridamole rest-stress [99mTc]sestamibi uptake ratio (UR).
METHODS: Twenty-five patients with suspect coronary artery disease (CAD) underwent rest, dobutamine, and dipyridamole [99mTc]sestamibi SPECT at 24-h intervals and coronary angiography. UR was calculated separately for each coronary territory considering injected dose and acquisition delay.
RESULTS: There were 38 CAD territories in 20 patients. On a patient basis, dipyridamole SPECT sensitivity was 85%, versus 70% for dobutamine. On a territory basis, sensitivity was 66% versus 42% (P<0.05), and specificity 92% versus 86%, respectively for dipyridamole versus dobutamine. In the 38 CAD territories, dipyridamole UR was -4.1±29.4%, and dobutamine UR was -13.1±19.9% (P<0.05). In the 37 no-CAD territories, UR was 34±23.6% for dipyridamole and -0.4±17.8% for dobutamine (P<0.0001). UR difference between CAD versus no-CAD territories was larger using dipyridamole (P<0.0001) than dobutamine (P<0.005).
CONCLUSIONS: The UR comparison confirms that [99mTc]sestamibi uptake underestimates the blood flow heterogeneity induced by dobutamine more than that produced by dipyridamole.

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