Ineffectiveness of dipyridamole SPECT thallium imaging as a screening technique for coronary artery disease in patients with end-stage renal failure

Transplantation. 1990 Jan;49(1):100-3. doi: 10.1097/00007890-199001000-00022.


The efficacy of dipyridamole single photon emission computed tomography (SPECT) thallium as a screening test for coronary artery disease (CAD), was studied in 45 patients with end-stage renal failure undergoing evaluation for renal transplantation. Coronary arteriography, dipyridamole SPECT thallium imaging and clinical follow-up were performed in all patients. Nineteen patients (42%) had an obstruction of 50% or more in at least one coronary artery. Fourteen patients had a positive thallium scan, but 7 of these were false-positives (sensitivity 37%, specificity 73%). The sensitivity was considerably lower than that quoted for non-ESRF patients in the literature, and significantly lower than a control group of 19 patients without ESRF having comparable severity and distribution of CAD. Five of the 6 patients who died of cardiac causes over a mean follow-up period of 25 months had normal thallium imaging, but all had significant coronary artery disease at cardiac catheterization. Dipyridamole SPECT thallium imaging has not proved a useful screening test for angiographically significant CAD, and does not predict cardiac prognosis in this population.

MeSH terms

  • Adult
  • Aged
  • Coronary Angiography
  • Coronary Disease / diagnostic imaging*
  • Dipyridamole*
  • False Negative Reactions
  • Female
  • Follow-Up Studies
  • Humans
  • Kidney Failure, Chronic / complications*
  • Male
  • Middle Aged
  • Thallium Radioisotopes*
  • Tomography, Emission-Computed*


  • Thallium Radioisotopes
  • Dipyridamole