Circulation, Vol 82, 998-1007, Copyright © 1990 by American Heart Association
RC Marshall, EM Leidholdt Jr, DY Zhang and CA Barnett
Technetium-99m hexakis 2-methoxy-2-isobutyl isonitrile (Tc-MIBI) and
thallium-201 extraction, washout, and retention were investigated and
compared in 20 isolated, isovolumic, retrograde blood-perfused rabbit
hearts at flow rates ranging from 0.5 to 3.5 ml/g wet wt min-1 in the
absence of tracer recirculation. Mean Tc-MIBI peak instantaneous extraction
was lower (0.55 +/- 0.10, p less than 0.001) and more affected by flow rate
(p less than 0.05) than 201Tl peak instantaneous extraction (0.83 +/-
0.06). In contrast, the rate of 201Tl washout was significantly faster (p
less than 0.05) and initially more dependent on perfusion rate (p less than
0.05) than Tc-MIBI washout. Reflecting its higher peak instantaneous
extraction, 201Tl retention was 55-79% higher immediately after isotope
injection (p less than 0.001) than Tc-MIBI retention, and relative changes
in maximal 201Tl net uptake correlated better (p less than 0.05) with
relative flow changes than maximal Tc- MIBI net uptake. However, due to its
faster washout rate, the superiority of thallium over Tc-MIBI as a
perfusion indicator was lost within 10 minutes of tracer injection under
the present single-pass experimental conditions. These data were
interpreted to indicate that 1) Tc-MIBI is not as well extracted and has a
slower washout rate than 201Tl; 2) varying the coronary flow rate has
significant but divergent effects on the extraction, washout, and retention
of Tc-MIBI and 201Tl; and 3) the present results support continued
evaluation of Tc-MIBI as a possible perfusion indicator.
ARTICLES
Technetium-99m hexakis 2-methoxy-2-isobutyl isonitrile and thallium-201 extraction, washout, and retention at varying coronary flow rates in rabbit heart
Cardiology Section, Veterans Affairs Medical Center, Martinez, Calif. 94553.
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