Japanese
Title新しい心筋血流シンチグラフィ製剤99mTc-Teboroxime (SQ30, 217) の臨床評価 - 第II相多施設共同試験 -
Subtitle原著
Authors石田良雄1,*, 小塚隆弘2, 大嶽達3, 佐々木康人3, 久保敦司4, 加藤千恵次6, 古舘正従6, 小林毅7, 高橋恒男8, 柳澤融8, 中居賢司9, 橋本省三4, 岩永史郎5, 森豊10, 川上憲司10, 島田孝夫11, 河村康明12, 山崎純一12, 森下健12, 古田昭一13, 田口淳一14, 大島統男15, 佐久間貞行15, 中嶋憲一16, 分校久志16, 久田欣一16, 柏木徹2, 越智宏暢17, 板金広18, 一矢有一19, 増田康治19, 飯尾正宏20,**
Authors(kana)
Organization1大阪大学医学部第一内科, 2放射線科, 3東京大学医学部放射線科, 4慶應義塾大学医学部放射線科, 5呼吸循環器内科, 6北海道大学医学部核医学講座, 7循環器内科, 8岩手医科大学放射線科, 9臨床検査医学科, 10東京慈恵会医科大学放射線科, 11第三内科, 12東邦大学医学部第一内科, 13三井記念病院循環器センター外科, 14内科, 15名古屋大学医学部放射線科, 16金沢大学医学部核医学科, 17大阪市立大学医学部核医学研究室, 18第一内科, 19九州大学医学部放射線科, 20日本アイソトープ協会, *論文執筆者, **治験総括医師
Journal核医学
Volume29
Number8
Page991-1003
Year/Month1992/8
Article原著
Publisher日本核医学会
Abstract「要旨」新しい99mTc標識心筋血流シンチグラフィ製剤である99mTc-Teboroximeの臨床第II相試験を, 12施設においてSPECTイメージング法(運動負荷時/安静時検査)を用いて実施した. 対象は, 心筋梗塞38例, 狭心症31例, その他の心疾患4例であった. 安全性については, 副作用, 臨床検査値ともに本剤との因果関係を示唆する異常の出現をみなかった. 画質の評価では62.5%がexcellentあるいはgoodと評価された. また良好な画質を得るために, SPECT撮像は投与後早期に開始し短時間で終了することが重要と考えられた. 本試験での陽性率は心筋梗塞では97.1%, 狭心症では62.1%であり, 冠動脈造影との一致率はそれぞれ84.4%, 68.0%, 201Tlとの一致率はそれぞれ78.1%, 74.1%であった. さらに総合評価においては95.8%に有用性が示され, 99mTc-Teboroximeによる心筋SPECTイメージングの臨床的有用性が認められた. 今後, 撮像条件の適正化のもとに, さらに検討が必要と思われた.
Practice臨床医学：一般
Keywords99mTc-Teboroxime, SPECT, Myocardial perfusion, 201Tl, Coronary artery disease.
English
TitleClinical Usefulness of Exercise/Rest 99mTc-Teboroxime SPECT Imaging : Results of a Japanese Multi-center Phase II Study
SubtitleOriginal Articles
AuthorsYoshio ISHIDA1, Takahiro KOZUKA2, Tohru OHTAKE3, Yasuhito SASAKI3, Atsushi KUBO4, Chietsugu KATO6, Masayori FURUDATE6, Takeshi KOBAYASHI7, Tsuneo TAKAHASHI8, Toru YANAGISAWA8, Kenji NAKAI9, Shozo HASHIMOTO4, Shiro IWANAGA5, Yutaka MORI10, Kenji KAWAKAMI10, Takao SHIMADA11, Yasuaki KAWAMURA12, Junichi YAMAZAKI12, Takeshi MORISHITA12, Shoichi FURUTA13, Junichi TAGUCHI14, Motoo OSHIMA15, Sadayuki SAKUMA15, Kenichi NAKAJIMA16, Hisashi BUNKO16, Kinichi HISADA16, Toru KASHIWAGI2, Hironobu OCHI17, Hiroshi ITAGANE18, Yuichi ICHIYA19, Kouji MASUDA19, Masahiro IIO20
Authors(kana)
Organization1First Department of Medicine, 2Department of Radiology, Osaka University Medical School, 3Department of Radiology, Faculy of Medicine, University of Tokyo, 4Department of Radiology, 5Department of Internal Medicine, School of Medicine, Keio University, 6Department of Nuclear Medicine, 7Department of Cardiovascular Medicine, Hokkaido University, School of Medicine, 8Department of Radiology, 9Department of Clinical Pathology, Iwate Medical University, School of Medicine, 10Department of Radiology, 11Third Department of Medicine, Jikei University School of Medicine, 12First Department of Internal Medicine, Toho University School of Medicine, 13Department of Surgery, 14Department of Internal Medicine, Center for Cardiovascular Disease, Mitsui Memorial Hospital, 15Department of Radiology, Nagoya University, School of Medicine, 16Department of Nuclear Medicine, School of Medicine, Kanazawa University, 17Division of Nuclear Medicine, 18First Department of Internal Medicine, Osaka City University, Medical School, 19Department of Radiology, Faculty of Medicine, Kyushu University, 20Japan Radioisotope Association
JournalThe Japanese Journal of nuclear medicine
Volume29
Number8
Page991-1003
Year/Month1992/8
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary]99mTc-Teboroxime [Chloro[tris(cyclohexyldioxime)methaneboronic acid] (99mTc) technetium], a perfusion agent for myocardial imaging, has a distinct advantage over 201Tl because of its very high myocardial extraction and is a 99mTc compound ideal for gamma camera imaging. This agent also demonstrates rapid myocardial washout, which allows completion of exercise and rest imaging studies in a short interval (to 1 hour). However, the rapid washout necessitates the completion of image acquisition very quickly after injection and therefore may require nonconventional SPECT imaging. In this Phase II study we evaluate the safety and efficacy of 99mTc-Teboroxime to detect coronary artery disease by exercise and rest SPECT imaging in 38 patients with prior myocardial infarction, 31 patients with angina pectoris, and 4 patients with non-coronary cardiac diseases. The 99mTc-Teboroxime dose used was 370-740 MBq in each study. The findings were compared with coronary angiography or 201Tl exercise and redistribution SPECT. No significant adverse reactions or laboratory abnormalities attributable to 99mTc-Teboroxime were observed. The quality of SPECT images was optimal in 62.5% of all patients. The relatively large population of suboptimal cases (37.5%) was attributed to the delay of the start and prolongation of the image acquisition time. In 85.7% of patients whose imaging was started within 5 minutes and completed within 11 minutes after injection, optimal quality was observed. Thus, 99mTc-Teboroxime SPECT requires the rapid completion of image acquisition after injection to achieve optimal image quality. Abnormalities of 99mTc-Teboroxime distribution were detected in 97.1% and 62.1% of patients with prior myocardial infarction or angina pectoris, respectively. The concordance with coronary angiography was 84.4% and 68.0%, and with 201Tl was 78.1% and 74.1%, respectively. Although standardization of the image protocol suitable for this agent is needed for the next study, these high correlations suggest the potential usefulness of 99mTc-Teboroxime SPECT imaging.
PracticeClinical medicine
Keywords99mTc-Teboroxime, SPECT, Myocardial perfusion, 201Tl, Coronary artery disease.

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