Clinical outcome of cardiac patients with negative thallium-201 SPECT and positive rubidium-82 PET myocardial perfusion imaging

In a previous comparison of 202 consecutive patients who underwent myocardial perfusion imaging with both ²⁰¹Tl SPECT and ⁸²Rb PET, 27 patients were identified as having true-positive ⁸²Rb images, but false- negative ²⁰¹Tl images. The purpose of this report is to determine the effect of correct image interpretation of coronary artery disease on the final management of those patients and compare it to the previous management scheme wherein a negative image was usually accepted as the end point unless clinical symptoms dictated otherwise. A follow-up study of the clinical course and outcome of these studies showed that 63% (17/27) of the patients with a true-positive ⁸²Rb PET image were recommended for revascularization procedures. It is doubtful that this majority of patients would have received either surgical or interventional management based on the false-negative ²⁰¹Tl SPECT procedure alone.