Evaluation of 201Thallium and 99mTc-Sestamibi Radiopharmaceuticals in detection of Ischemic Heart Disease

Abstract

Ischemic heart disease (IHD) recently have been consider as one of the major reasons of morbidity, it’s defined as reduction of blood supply to the heart muscle, which is supplied by the coronary arteries in case of partial or complete occlusion in one or more of the coronary arteries the myocardial tissues begins to die, Nuclear Medicine plays an important role in detection of ischemic heart disease either reversible or irreversible (IHD), using a dedicated radiopharmaceuticals in detection clinically, the most commonly used radiopharmaceuticals are 99mTc-Sestamibi,99mTc-Tetrofosmin and 201Tl . This study focused on using counts/second /pixel(c/s/p),reversibility% among arteries i.e. LAD,LCX and RCA in evaluation of 99mTc-MIBI and 201TL biodistribution in both conditions of stress and rest, and the factors affecting reversibility such as age, gender and obesity ,in addition to prevalence among genders, in the period from Feb.2014 until Jun.2016 a sample of one hundred and fifty patients with known ischemic heart disease (IHD) underwent Myocardial perfusion imaging (MPI) , using the slandered Bruce protocol of exercise and applying one day protocol, patients were classified into two groups Group(I): A sample of 73 patients (42 males) (31 Females) ) were administrated with 99mTc-MIBI Group (II) :A sample of 77 (56 males) (21 females) injected with 74 to 111 MBq (2 to 3 mCi) of 201TL,the obtained data was analyzed using QPS,Cedar , and Excel retrospectively. The study results showed that the radiopharmaceuticals used in nuclear medicine have great capability to detect ischemic heart disease and Tl201 is the preferable radiopharmaceutical for detection of (IHD), Left anterior descending artery (LAD) is the most involved artery in ischemic heart disease, and the preferable radiopharmaceutical for detection of coronary artery disease is 99mTc-Sestamibi ,the study also revealed that the age of risk for this disease is 50-70 years , and the other factors such as obesity has a huge negative effect on development of IHD, the study also showed that the percentage of prevalence of IHD is higher among men in relevant to women and the reversibility among men is less in comparison to women and prevalence risk is relatively the same for both genders at the age after seventy years.