Research ArticleCLINICAL INVESTIGATIONS

Quantitative Diagnostic Performance of Myocardial Perfusion SPECT with Attenuation Correction in Women

Arik Wolak, Piotr J. Slomka, Mathews B. Fish, Santiago Lorenzo, Daniel S. Berman and Guido Germano
Journal of Nuclear Medicine June 2008, 49 (6) 915-922; DOI: https://doi.org/10.2967/jnumed.107.049387

Article Figures & Data

Figures

  • FIGURE 1. 
    FIGURE 1. 

    Correlations and bias plots (Bland–Altman analysis) for SSS and TPD and for NC and AC.

  • FIGURE 2. 
    FIGURE 2. 

    Comparison of quantitative results obtained with NC and AC for SSS abnormality threshold of ≥3. NS = not significant.

  • FIGURE 3. 
    FIGURE 3. 

    ROC curves for detection of ≥70% stenosis with SSS (A) and TPD (B).

  • FIGURE 4. 
    FIGURE 4. 

    ROC curves for detection of ≥70% stenosis by coronary artery territory.

  • FIGURE 5. 
    FIGURE 5. 

    Comparison of quantitative results obtained with NC and AC for TPD abnormality threshold of ≥3. NS = not significant.

  • FIGURE 6. 
    FIGURE 6. 

    Examples for 3 cases. (A) 55-y-old hypertensive, obese (BMI = 35) patient who had atypical chest pain and who underwent pharmacologic stress MPS. Coronary angiography revealed no evidence of CAD. NC image (top) revealed basal inferior perfusion defect in territory of RCA, whereas AC image (bottom) depicted normal study. (B) 67-y-old overweight (BMI = 26), hypertensive, dyslipidemic, diabetic patient who underwent exercise stress MPS. NC image (top) depicted normal study, whereas AC image (bottom) revealed perfusion defect in territory of LAD. This perfusion defect might have been attributable to apical thinning apparent on AC but not NC studies. (C) 62-y-old hypertensive, diabetic, dyslipidemic, morbidly obese (BMI = 40) patient who had atypical chest pain and who underwent pharmacologic stress MPS. Coronary angiography revealed 90% RCA stenosis. NC image (top) revealed minimal nonsignificant perfusion defect. AC image (bottom), however, correctly revealed basal inferior perfusion defect in territory of RCA.

Tables

  • TABLE 1

    Patient Characteristics

    ParameterDatabase group (n = 50)LLk group (n = 134)Angiography group (n = 114)
    Age (y), mean ± SD56.7 ± 14.752.2 ± 5.065.2 ± 21.2
    BMI (kg/m2), mean ± SD30.5 ± 6.228.3 ± 15.230.7 ± 6.0
    BMI of ≤3025 (50)96 (70)65 (47)
    Diabetes8 (16)12 (9)35 (30)
    Hypertension22 (44)57 (42)84 (73)
    Hypercholesterolemia19 (38)47 (34)53 (46)
    Chest pain12 (24)54 (39)85 (74)
    Adenosine0 (0)0 (0)143 (76)

    • Data are reported as number (percentage), unless otherwise indicated.

  • TABLE 2

    Angiographic Characteristics for 114 Patients

    ParameterNo. (%) of patients
    No stenosis*45 (40)
    Single-vessel disease31 (27)
    Double-vessel disease23 (20)
    Triple-vessel disease15 (13)
    LAD disease55 (48)
    LCX disease46 (40)
    RCA disease51 (45)

    • ↵* Stenosis of ≥70% luminal diameter narrowing was considered significant.

  • TABLE 3

    Quantitative Parameters Obtained for AC and NC Data

    Mean ± SD for:
    Parameter (no. of patients)NCACP
    SSS–all (114)6.7 ± 8.26.9 ± 8.00.5
    SSS–no CAD (45)1.6 ± 2.31.8 ± 2.50.6
    SSS–CAD (69)10.0 ± 9.010.2 ± 8.50.6
    SSS–LLk (134)0.5 ± 10.6 ± 1.20.23
    TPD–all (114)8.5 ± 11.59.4 ± 11.70.07
    TPD–no CAD (45)1.6 ± 2.42.1 ± 2.60.2
    TPD–CAD (69)12.9 ± 12.914.1 ± 12.10.1
    TPD–LLk (134)0. 4 ± 1.00.7 ± 1.10.18
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