TID on lexiscan?

[tjsfanatic]

Do y'all call it abnormal if it's elevated every time, or only if there's also ischemia/infarct present? I find it to be so imprecise...

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[Matsumoto99]

It should be described as elevated when TID is present. It can be a sign of multi-vessel disease and balanced ischemia so whether or not there is a perfusion abnormality is irrelevant, since theoretically you should see TID in these severe MVD cases where you worry about balanced reduction in uptake.

 

[Cardiac Amyloidosis]

It should be described as elevated when TID is present. It can be a sign of multi-vessel disease and balanced ischemia so whether or not there is a perfusion abnormality is irrelevant, since theoretically you should see TID in these severe MVD cases where you worry about balanced reduction in uptake.

Well when you study for nuclear boards they emphasis over and over that it holds no clinical relevance if there is no defect with it.

 

[Matsumoto99]

Ah I see. I was just answering based off my clinical training/day to day but maybe board prep is different.. If I had an MPI with TID and multi-vessel calcium on the CT for instance and no perfusion defect I would likely test the patient further.

 

[shouldigomd]

On SPECT I don't give TID much value. In SPECT the imaging after "stress" is way too long and the imaging way too imprecise to really show TID. Basically like having a patient wait there for 15 minutes before you obtain your stress echo pics. That being said my approach to stress testing is calling it like it is. If there is TID I say its abnormal.

PET on the other hand can show TID since the stress imaging is done much sooner and the image quality much better.