Clinical comparison of 180-degree and 360-degree data collection of technetium 99m sestamibi SPECT for detection of coronary artery disease.

Background: With multihead gamma cameras both 180- and 360-degree acquisitions of myocardial perfusion are feasible. However, with 99mTC-labeled sestamibi (99mTC-sestamibi) the optimal clinically relevant demonstration of the superiority of 180- versus 360-degree data acquisition has not been performed.

Methods: Seventy-two consecutive patients undergoing 99mTC-sestamibi imaging at rest and stress who had coronary angiography performed within 3 months were enrolled.

Patients with symptomatic ischemia have larger thallium perfusion abnormalities and more adverse prognosis than patients with silent ischemia.

Objective: To evaluate the mechanism for silent ischemia and the effect on prognosis.

Design: To test the hypothesis that patients with silent (compared with symptomatic) ischemia have less severe ischemia and a more favorable prognosis, the authors prospectively evaluated 152 consecutive patients with a positive exercise electrocardiogram with exercise thallium scintigraphy and followed them for two years.

Setting: Tertiary care university-based hospital.

A bullseye display of regional perfusion of the brain.

The authors submit a method of viewing Tc-99m HMPAO SPECT images of the brain based on the principles of the myocardial bullseye or polar mapping. Commercially available software for the production of a myocardial bullseye display is suitable for the preparation of a bullseye display of regional perfusion image of the brain. This display facilitates the detection of cerebral cortical perfusion defects by displaying all SPECT oblique slices concentrically from base to vertex in a single image.