Stress echocardiography versus radionuclide stress techniques

The different modalities of stress echocardiography and stress thallium-201 imaging have comparable sensitivity, specificity, and overall predictive accuracy in the diagnosis and prognosis of coronary artery disease. They are also comparable in the assessment and follow-up of patients treated with thrombolytic therapy or who have undergone percutaneous transluminal coronary angioplasty and coronary artery bypass graft surgery. Stress radionuclide ventriculography has a lower sensitivity and specificity as compared to stress echocardiography and stress thallium. Dipyridamole thallium has a higher sensitivity as compared to dipyridamole echocardiography in the diagnosis and prognosis of coronary artery disease. New techniques such as dobutamine echocardiography, adenosine stress thallium-201, and adenosine echocardiography have individually shown high sensitivities, specificities, and accuracy. However, further studies are needed on their comparative value. The major advantages of stress echocardiography over radionuclide stress techniques are: lack of radiation exposure; less expense; less time consumption; less personnel required; and greater availability. Its major disadvantage, however, is the inability to obtain adequate studies in all patients.