The impact of Technetium-99m MIBI myocardial perfusion scintigraphy SPECT imaging, in the management of patients with intermediate coronary artery lesions

Abstract

The new challenge for nuclear cardiology is to determine whether its techniques can provide more accurate information than other competitive modalities. Nuclear examinations may be used when the results of coronary angiography are equivocal regarding the hemodynamic significance of a lesion, such as in patients with intermediate coronary artery disease. In these cases, scintigraphy may aid to separate the patients who are non-ischaemic and who require just medical treatment, from those who have ischaemia and who thus require revascularisation. This is the current practice in Malta. This research project was designed to evaluate whether the results of the scintigraphy studies have an impact on the management and treatment proposed for patients with intermediate coronary artery lesions. It also aimed to show whether the myocardial perfusion examinations being performed are reaching their goal of detecting the presence and site of any ischaemia present. 29 cardiac cases were chosen for this study and criteria were set to exclude those patients that would have biased the research. The results obtained demonstrate that the scintigraphy examinations currently carried out are adequately fulfilling their role. Moreover the results of the scintigraphy studies were seen to covary with the treatment proposed for the participants, in about 90% of cases. So it was concluded that the perfusion examinations have an impact on the management of patients with intermediate lesions.