HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH RSS TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: jnumed.106.039107v1 48/10/1670    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Related articles in JNM Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Giorgetti, A. Search for Related Content PubMed PubMed Citation Articles by Giorgetti, A.

Feasibility and Diagnostic Accuracy of a Gated SPECT Early-Imaging Protocol: A Multicenter Study of the Myoview Imaging Optimization Group

CNR Institute of Clinical Physiology, Pisa, Italy

Correspondence: For correspondence or reprints contact: Assuero Giorgetti, MD, CNR Institute of Clinical Physiology, Via Moruzzi 1, 56124, Pisa, Italy. E-mail: asso{at}ifc.cnr.it

The aim of this study was to investigate whether early (time 1, or T1) myocardial tetrofosmin imaging is feasible and as accurate in detecting coronary artery disease as is standard delayed (time 2, or T2) imaging. Methods: One hundred twenty patients (100 men and 20 women; mean age ± SD, 61 ± 10 y) with anginal symptoms underwent tetrofosmin gated SPECT. Stress/rest T1 imaging was performed at 15 min and T2 at 45 min after injection. Image quality was visually evaluated using a 4-point scale (from 0 = poor to 3 = optimal). Myocardial perfusion analysis was performed on a 20-segment model using quantitative perfusion SPECT software, and reversible ischemia was scored as a summed difference score (SDS). Coronary angiography was performed within 1 mo on all patients, and stenosis of more than 50% of the diameter was considered significant. Results: Overall, quality was scored as optimal or good for 94% of T1 images and 95% of T2 images (P = not statistically significant). Heart, lung, liver, and subdiaphragmatic counts did not differ for stress and rest T1 and T2 imaging. A good linear relationship was seen between T1 and T2 SDS (r = 0.69; P < 0.0001), and Bland–Altman analysis showed good agreement between the 2 conditions. In terms of global diagnostic accuracy, areas under the receiver-operating-characteristic curve were comparable between T1 and T2 (0.80 vs. 0.81, P = not statistically significant). Discrepancies between T1 and T2 SDS were observed in 44% of patients (T1 – T2 SDS > 2). Linear regression analysis showed a good correlation between T1 and T2 SDS (r = 0.67; P < 0.0001), whereas the Bland–Altman method showed a shift in the mean value of the difference of +2.67 ± 2.73. In patients with a T1 – T2 SDS of more than 2, areas under the receiver-operating-characteristic curves were significantly higher for T1 than for T2 images (0.79 vs. 0.70, P < 0.001). Conclusion: T1 imaging is feasible and as accurate as T2 imaging in identifying coronary artery disease. However, in a discrete subset of patients, early acquisition strengthens the clinical message of defect reversibility by permitting earlier, more accurate identification of more severe myocardial ischemia.

Key Words: tetrofosmin • gated SPECT • myocardial imaging • early imaging • delayed imaging • coronary artery disease

COPYRIGHT © 2007 by the Society of Nuclear Medicine, Inc.

Related articles in JNM:

This Month in JNM

JNM 2007 48: 11A-12A. [Full Text]  

This article has been cited by other articles:

				B. A. Herzog, R. R. Buechel, R. Katz, M. Brueckner, L. Husmann, I. A. Burger, A. P. Pazhenkottil, I. Valenta, O. Gaemperli, V. Treyer, et al. Nuclear Myocardial Perfusion Imaging with a Cadmium-Zinc-Telluride Detector Technique: Optimized Protocol for Scan Time Reduction J. Nucl. Med., January 1, 2010; 51(1): 46 - 51. [Abstract] [Full Text] [PDF]

				E. Fommei, L. Bruselli, A. Ripoli, A. Gimelli, S. Ghione, A. Giorgetti, A. Kush, I. D. Tagliavia, C. Passino, and P. Marzullo Single-Shot Cardiorenal Scintigraphy with 99mTc-Tetrofosmin: A Dynamic Characterization at Rest and During Adenosine Infusion J. Nucl. Med., August 1, 2009; 50(8): 1288 - 1295. [Abstract] [Full Text] [PDF]

				I. Ali, T. D. Ruddy, A. Almgrahi, F. G. Anstett, and R. G. Wells Half-Time SPECT Myocardial Perfusion Imaging with Attenuation Correction J. Nucl. Med., April 1, 2009; 50(4): 554 - 562. [Abstract] [Full Text] [PDF]