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Original research article


Comparative Performances of Dipyridamole and Regadenoson to Detect Myocardial Ischemia using Cardiac Cadmium-Zinc-Telluride Single-Photon Emission Computerized Tomography.

Fayçal Ben Bouallçgue1,2,3Catherine Nganoa3Jonathan Vigne3Denis Agostini3Alain Manrique3,4
1Department of Nuclear Medicine, Montpellier University Hospital, 2PhyMedExp, INSERM – CNRS, Montpellier University, Montpellier, 3Department of Nuclear Medicine, CHU de Caen, 4Normandie University, UNICAEN, EA 4650 SEILIRM, GIP Cyceron, Caen, France
Date of Submission: 12-Sep-2017, Date of Acceptance: 20-Aug-2018, Date of Web Publication: 15-Nov-2018.
Corresponding Author:
Corresponding Author

Fayçal Ben Bouallègue

Department Nuclear Medicine, Montpellier University Hospital, 371 Av. du Doyen Gaston Giraud, 34090 Montpellier, France.
E-mail: faybenb@hotmail.com

Corresponding Author:
Corresponding Author

Fayçal Ben Bouallègue

Department Nuclear Medicine, Montpellier University Hospital, 371 Av. du Doyen Gaston Giraud, 34090 Montpellier, France.
E-mail: faybenb@hotmail.com

DOI: 10.4103/jcis.JCIS_71_17 Facebook Twitter Google Linkedin

ABSTRACT


Objective: We evaluated the relative performances of dipyridamole (Dip) and regadenoson (Reg) in a cohort of patients referred for coronary artery disease diagnosis or follow-up using myocardial perfusion imaging. Materials and Methods: We retrospectively included 515 consecutive patients referred for 99mTc-sestamibi myocardial perfusion single-photon emission computerized tomography (SPECT) on a cadmium-zinc-telluride (CZT) camera after pharmacologic stress. About three quarters (n = 391, 76%) received Dip. Reg was administrated to patients with chronical respiratory disease or with body mass index (BMI) over 38 kg/m² (n = 124, 24%). Patients with an abnormal stress scan (92%) underwent a rest imaging on the same day. Qualitative interpretation of perfusion images was achieved using QPS software, and the ischemic area was assessed using the 17-segment model. In patients undergoing a stress-rest protocol, perfusion polar plots were postprocessed using automated in‑house software to quantify the extension, intensity, and location of the reversible perfusion defect. Statistical comparison between groups was performed using univariate and multivariate analysis. Results: Qualitative analysis concluded to myocardial ischemia in 70% of the patients (69% in the Dip group, 76% in the Reg group, P = ns). In those patients, the number of involved segments (Dip 2.5 ± 1.6, Reg 2.7 ± 1.6, P = ns) and the proportion of patients with an ischemic area larger than two segments (Dip 30%, Reg 37%, P = ns) were comparable. Automated quantification of the reversible perfusion defect demonstrated similar defect extension, intensity, and severity in the two groups. Defect location was identical at the myocardial segment and vascular territory scales. Conclusions: Reg and Dip showed equal performances for ischemic burden characterization using myocardial CZT SPECT.
Keywords: Cadmium-zinc-telluride camera, dipyridamole, myocardial perfusion single-photon emission computerized tomography, pharmacologic stress, regadenoson

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