Improved quantification and normal limits for myocardial perfusion stress-rest change.

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
Mithun PrasadGuido Germano

Abstract

We aimed to improve the quantification of myocardial perfusion stress-rest changes in myocardial perfusion SPECT (MPS) studies for the optimal automatic detection of ischemia and coronary artery disease (CAD). Rest-stress (99m)Tc MPS studies (997 cases; 651 consecutive cases with correlating angiography and 346 cases with less than 5% likelihood (low likelihood [LLK]) of CAD) were analyzed. Normal limits for stress-rest changes were derived from additional LLK patients (40 women, 40 men). We computed the global stress-rest change (C-SR) by integrating direct stress-rest changes for each polar map pixel. Additionally, stress-rest change and total perfusion deficit (TPD) at stress were combined in 1 variable (C-TPD) for the optimal detection of CAD. The area under the receiver-operating-characteristic curve (AUC) for C-SR (0.92) was larger than that for stress TPD-rest TPD (0.88) for the identification of stenosis of 70% or more (P < 0.0001). AUC (0.94) and sensitivity (90%) for C-TPD were higher than those for stress TPD (0.91 and 83%, respectively) (P < 0.0001), whereas specificity remained the same (81%). C-SR and C-TPD provide higher diagnostic performance than difference between stress and rest TPD or stress hypoperfusion an...Continue Reading

References

Jun 14, 1979·The New England Journal of Medicine·G A Diamond, J S Forrester
Aug 6, 2003·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Kim A WilliamsHemlata K Pokharna
Feb 1, 2005·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Piotr J SlomkaGuido Germano
Aug 22, 2006·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Tali SharirDaniel S Berman
Sep 2, 2006·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Piotr J SlomkaGuido Germano
Feb 6, 2007·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Guido GermanoDaniel S Berman
May 17, 2008·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Arik WolakGuido Germano

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Citations

Feb 4, 2012·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Piotr SlomkaGuido Germano
May 25, 2013·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Reza ArsanjaniPiotr J Slomka
Feb 18, 2014·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Helen FranssonEinar Heiberg
Mar 5, 2016·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Bastien GregoireChristian Scheiber
Nov 23, 2015·Cardiology Clinics·Manish MotwaniPiotr Slomka
Feb 7, 2018·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Abhishek C SawantSamir Kapadia
Feb 23, 2018·European Journal of Nuclear Medicine and Molecular Imaging·R S DriessenP Knaapen
Oct 18, 2020·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Piotr J SlomkaErnest V Garcia
Jan 19, 2012·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Srinivasan SenthamizhchelvanGeorge Sgouros
Oct 18, 2020·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Piotr J SlomkaErnest V Garcia

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