Stress and Rest Myocardial Tomoscintigraphies Using Mono- or Double-isotope Protocol With a Semiconductor Camera

NCT ID: NCT02869126

Last Updated: 2016-08-16

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 118 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2012-09-30
• Study Completion Date: 2015-11-30

Brief Summary

The purpose is to demonstrate the concordance of diagnostic information obtained with:

1. a conventional examination with 2 distinct recordings on D.SPECT camera after 99mTc-sestamibi injections, the first post-stress and the second at rest, 2 to 3 hours later,

and

2. a double isotope examination with a supplementary recording after injection of a little activity of thallium-201 at rest after the first recording and before the second injection of 99mTc-sestamibi for conventional recording at rest,

in patients showing abnormalities of myocardial perfusion in stress myocardial tomoscintigraphy.

Detailed Description

Myocardial perfusion tomoscintigraphy is very used for diagnosis and characterization of abnormalities of stress and rest myocardial perfusion. This examination can be performed with semiconductor gamma cameras that are more performant than conventional cameras regarding spatial resolution, detection sensitivity and energy resolution.

The amelioration of energy resolution could allow the realization of simultaneous recordings of a dye injected at rest and another injected during stress (double isotope recording), while conventional examination needs 2 different recordings, stress and rest, separated from several hours.

In this study patients undergo a conventional examination with D.SPECT camera with 2 recordings, the first after injection of a little activity of 99mTc-sestamibi at stress (≤ 100 MBq) and the second, 2 hours later, after injection at rest of a 3 time bigger activity of 99mTc-sestamibi (≤ 300 MBq). An activity of thallium-201(≤ 50 MBq) is injected at rest after the first recording of stress. 5 minutes later, a supplementary double isotope recording is realized with D.SPECT camera (99mTc-Sestamibi-stress / thallium201-rest).

The demonstration of the hypothesis of this study could considerably diminish the duration of the examination (from 3 to 4 hours to less than 1 hour).

Conditions

Myocardial Perfusion

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: DIAGNOSTIC
• Blinding Strategy: NONE

Study Groups

Patients

Patients with abnormalities of myocardial perfusion detected with stress tomoscintigraphy, undergo double isotope myocardial tomoscintigraphy using Thallium-201 and 99mTc-sestamibi and traditional myocardial tomoscintigraphy using 99mTc-sestamibi with a semiconductor camera

Group Type: EXPERIMENTAL

Tomoscintigraphy with D.SPECT camera (SPECTRUM Dynamics®, Israel)

Intervention Type: PROCEDURE

• During stress test, intravenous injection of 99mTc-Sestamibi (between 80 and 150 MBq according to weight) in patient
• Stress conventional acquisition with D.SPECT camera 20 min after injection
• 60 min after 99mTc-Sestamibi injection, rest injection of thallium-201 (50% activity of stress 99mTc-Sestamibi)
• double isotope acquisition 5 min after thallium-201 injection
• injection of 99mTc-Sestamibi at rest (activity 3 times higher), after 2 hours from first 99mTc-Sestamibi injection
• rest conventional acquisition 20 min later

99mTc-Sestamibi

Intervention Type: DRUG

First intravenous injection between 80 and 150 MBq according to patient weight and second injection with 3-time-higher activity, 2 hours after the first

For tomoscintigraphy

Thallium-201

Intervention Type: DRUG

Injection of thallium-201 (50% activity of first 99mTc-Sestamibi injection)

For tomoscintigraphy

Interventions

Tomoscintigraphy with D.SPECT camera (SPECTRUM Dynamics®, Israel)

• During stress test, intravenous injection of 99mTc-Sestamibi (between 80 and 150 MBq according to weight) in patient
• Stress conventional acquisition with D.SPECT camera 20 min after injection
• 60 min after 99mTc-Sestamibi injection, rest injection of thallium-201 (50% activity of stress 99mTc-Sestamibi)
• double isotope acquisition 5 min after thallium-201 injection
• injection of 99mTc-Sestamibi at rest (activity 3 times higher), after 2 hours from first 99mTc-Sestamibi injection
• rest conventional acquisition 20 min later

Intervention Type: PROCEDURE

99mTc-Sestamibi

First intravenous injection between 80 and 150 MBq according to patient weight and second injection with 3-time-higher activity, 2 hours after the first

For tomoscintigraphy

Intervention Type: DRUG

Thallium-201

Injection of thallium-201 (50% activity of first 99mTc-Sestamibi injection)

For tomoscintigraphy

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• > 18, without guardianship, signed informed consent
• Without contraindication for myocardial perfusion tomoscintigraphy and stress technique (dipyridamole and/or effort), according to common criteria to French Societies of Cardiology and Nuclear Medicine, as it is requested for all patients needing this routine examination
• Not in life-and-death emergency, with a stable clinical state (without cardiac insufficiency or instable coronary, without hypertension not well-stabilized under treatment)
• Effective contraceptive method for women of childbearing potential
• Weight ≤ 100 kg (> 100 kg patients need higher injected activities in order to obtain adequate image quality)
• Perfusion abnormalities on stress images

Exclusion Criteria

• < 18
• Contraindications to stress test (effort and/or dipyridamole)
• Hypersensibility to thallium201 chloride or one of excipients
• Claustrophobic patient or incapable to stay lying down for 30 minutes
• Pregnancy or doubt of pregnancy
• Breastfeeding woman
• Weight > 100 kg
• Non affiliation to social security plan

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Central Hospital, Nancy, France

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Wassila DJABALLAH, Dr

Role: PRINCIPAL_INVESTIGATOR

Service de Médecine Nucléaire, Hôpital de Brabois, 54511 Vandœuvre les Nancy

Locations

Service de Médecine Nucléaire - CLCC Jean Perrin

Clermont-Ferrand, , France

Service de Médecine Nucléaire - Hôpital de Brabois

Vandœuvre-lès-Nancy, , France

Countries

France

Other Identifiers

2012-A00569-34

Identifier Type: -

Identifier Source: org_study_id