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3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of Nuclear Congress Medicine of Nuclear Medicine Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011 99mTc-MIBI INFUSION VERSUS NITROGLYCERIN 99mTc-MIBI ON DETECTION OF MYOCARDIAL VIABILITY Shahram Dabiri Oskoei 1 , Babak Mahmoudian 2 1 Tabriz University of Medical Science, Department of Nuclear Medicine 2 Tabriz Gamma Scan Nuclear Medicine Center Objectives: Several studies have suggested that, rest 99mTc-MIBI underestimates the extent of viable myocardium. This study aimed to test whether 99mTc-MIBI infusion could increment the capacity of 99mTc-MIBI to detect myocardial viability and to compare it with sublingual administration of nitroglycerine (TNG) before 99mTc-MIBI injection in the same sample. Method: Twenty patients (14 men, 6 women, mean age 51.5 ± 9.5 years) with previous myocardial infarction (mean evolution 6.5 ± 4 months) were submitted to myocardial perfusion scan with 99mTc- MIBI gated SPECT for evaluation of myocardial viability. Rest imaging, TNG 99mTc-MIBI scan and infusion of 99mTc-MIBI during 30 minutes were performed in all patients. Acquisition was started 60 minutes after starting of radiotracer infusion or injection. The uptake more than 50% of maximum activity on each segment of bull’s eye images was considered as viable tissue. Increased uptake more than 5% in comparison to rest study was considered significant. Results: A total of 660 myocardial segments were analyzed, of which 112(17%) showed viability on rest images. Viable tissue was observed in 135 segments (20.4%) on rest TNG99mTc-MIBI scan with significant increased uptake in 16 (2.4%) other segments. After 99mTc-MIBI infusion, viability was seen on 132 segments (20%) and significant increased uptake in 18 (2.7%) other segments. All above mentioned segments were hypokinetic. Conclusion: Resting 99mTc-MIBI infusion imaging, with improved tracer delivery, may overcome some of the inadequacies of standard stress/rest 99mTc-MIBI imaging for assessing myocardial viability. The implication of this observation is that resting 99mTc-MIBI infusion scintigraphy can provide useful information when evaluating patients for the presence of hibernating myocardium. A prospective comparison of resting 99mTc-MIBI infusion scintigraphy with other noninvasive techniques which are used to identify viable myocardium may thus be warranted. Keywords: Myocardium, Perfusion, SPECT, MIBI, Infusion, Viability 54
3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of Congress of Nuclear Medicine Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011 Gated myocardial perfusion SPECT: patient position effect Vahid Reza Dabbagh Kakhki Mash’had University of Medical Science, Nuclear Medicine Research Center Objectives: Gated myocardial perfusion SPECT has traditionally been performed with the patient in the supine position. Prone position imaging is used to rule out of diaphragmatic attenuation. The main of this study was evaluation of patient position effect on left ventricular end-diastolic & end-systolic volumes (EDV & ESV) as well as left ventricular ejection fraction (LVEF) acquired on gated myocardial perfusion SPECT. Methods: Sixty patients (40 males and 20 females) with mean age: 52.1±8.8 were studied. All patients underwent rest gated Tc99m- MIBI myocardial perfusion SPECT on both prone and supine positions. Gated images were analyzed by QGS software and EDV, ESV and LVEF were calculated for both supine and prone images. Results: EDV, ESV and stoke volume (SV) were significantly lower in prone positions, while no significant difference was noticed in LVEF between prone and supine positions. Heart rate (HR) was significantly lower on supine position as compared to the prone position (67.30 ± 9.54 vs. 71.87 ± 9.56; P
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