Diagnostic usefulness of myocardial SPECT with 123I-β-methyl-iodophenyl pentadecanoic acid and 201Tl in unstable angina

The purpose of this study is whether 123I-BMIPP detects a culprit lesion in patients with unstable angina. Twenty-six patients with unstable angina underwent 123I-BMIPP (BMIPP) and 201Tl (Tl) imaging at rest. BMIPP image was compared with Tl imaging. BMIPP imaging revealed defects or low uptake corresponding to myocardial ischemic areas predicted by coronary angiography in 19 (73.1%) of 26 patients. Tl imaging showed defects or low uptake corresponding to coronary angiographic findings in 14 (53.8%). BMIPP demonstrated significantly less uptake than Tl (p=0.001). Severity of reduced BMIPP activity was greater than that of Tl (p<0.001). We concluded that BMIPP imaging was excellent in detecting culprit lesions in patients with unstable angina. BMIPP SPECT is a sensitive method for detecting myocardium exposed to transient schemia that cannot be detected by Tl imaging. (author)