Coronary Artery Disease Clinical Trial
Official title:
Stress Thallium-201/Rest Technetium-99m Sequential Dual Isotope High-Speed Myocardial Perfusion Imaging Validation Versus Invasive Coronary Angiography
The new cadmium-zinc-telluride (CZT) technology is a powerful tool for cardiac nuclear medicine. The increased photon counting sensitivity of camera can be used to explore novel protocols like dual isotope (rapid stress Tl-201/rest Tc-99m protocol for use with high-speed SPECT MPI). The use of dual isotope imaging is very interesting because this imaging combines the use of thallium-201 with technetium-99m agents permitting optimal image resolution and simultaneous assessment of viability, all with an exam duration of approximately 20 minutes. However, no study compares stress thallium-201/rest technetium-99m sequential dual isotope high-speed myocardial perfusion imaging versus invasive coronary angiography. The investigators report here the first validation of high-speed protocol with dual isotope for myocardial perfusion imaging using invasive coronary angiography as the standard of reference.
The new cadmium-zinc-telluride (CZT) technology is a powerful tool for cardiac nuclear
medicine. Indeed, recent clinical validation studies of CZT technology have documented a
scan time reduction and low radiation dose without degradation of myocardial perfusion
imaging in comparison with standard dual detector cameras. The increased photon counting
sensitivity of camera can be used to explore novel protocols that may offer advantages over
standard protocols used for Myocardial Perfusion Imaging. Berman et al. showed that rapid
stress Tl-201/rest Tc-99m protocol for use with high-speed SPECT MPI has offered the
superior qualities of Tl-201 for stress imaging and of the Tc-99m agents for rest imaging
can be preserved. Nuclear medicine presents the most level of scientific validation for
diagnosis and prognosis of coronary artery disease. A lot of studies have compared
performance of standard dual detector cameras vs. Invasive Coronary Angiography. Fiechter et
al. reported the first validation of ultrafast dedicated cardiac gamma camera with CZT
versus invasive coronary angiography. But he used a novel hybrid SPECT /CT device and
99m-Tc-tetrofosmin pharmacological stress/rest examination. However, no study compares
stress thallium-201/rest technetium-99m sequential dual isotope high-speed myocardial
perfusion imaging versus invasive coronary angiography. Moreover, diagnosis performance of
this high-speed protocol versus fractional flow reserve for stenosis evaluation is unknown.
The investigators report here the first validation of high-speed protocol with dual isotope
for myocardial perfusion imaging using invasive procedures (coronary angiography and
fractional flow reserve) as the standard of reference.
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Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Diagnostic
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