Sequential dual-isotope SPECT imaging with thallium-201 and technetium-99m-sestamibi

J Nucl Med. 1994 Apr;35(4):549-53.


This study examined the results of sequential SPECT dual-isotope imaging with 201Tl and 99mTc-sestamibi in 148 patients, 114 of whom also had coronary angiography and 34 had < 5% pretest probability for coronary artery disease (CAD).

Methods: Stress thallium/rest sestamibi was used in 82 patients and rest thallium/stress sestamibi in 66 patients. Coronary angiography showed that 17 patients had no CAD, 27 patients had one-vessel CAD, 41 patients had two-vessel CAD and 29 patients had three-vessel CAD. The thallium study (3 mCi) was always done before the sestamibi study (20-25 mCi). The stress was either symptom-limited treadmill exercise testing or adenosine infusion at a rate of 140 micrograms/kg/min for 6 min.

Results: The study was completed within 2 hr. The stress and rest images were normal in 11 of 17 patients (65%) with no CAD by angiography and in 33 of 34 patients with a low pretest probability of CAD (normalcy rate = 97%). The images were abnormal in 75 patients with CAD (77%). The perfusion pattern was compared to wall motion in 485 segments (97 patients) assessed by contrast ventriculography. There were no or reversible perfusion defects in 357 of 386 segments (92%) with no wall motion abnormality.

Conclusion: Sequential dual-isotope imaging is feasible and can be completed in a short period of time and may therefore enhance laboratory throughput and patient convenience.

MeSH terms

  • Aged
  • Coronary Angiography
  • Coronary Disease / diagnostic imaging
  • Exercise Test
  • Female
  • Heart / diagnostic imaging*
  • Humans
  • Male
  • Middle Aged
  • Sensitivity and Specificity
  • Technetium Tc 99m Sestamibi*
  • Thallium Radioisotopes*
  • Tomography, Emission-Computed, Single-Photon*


  • Thallium Radioisotopes
  • Technetium Tc 99m Sestamibi