RT Journal Article
SR Electronic
T1 Improved Quantification and Normal Limits for Myocardial Perfusion Stress–Rest Change
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 204
OP 209
DO 10.2967/jnumed.109.067736
VO 51
IS 2
A1 Mithun Prasad
A1 Piotr J. Slomka
A1 Mathews Fish
A1 Paul Kavanagh
A1 James Gerlach
A1 Sean Hayes
A1 Daniel S. Berman
A1 Guido Germano
YR 2010
UL http://jnm.snmjournals.org/content/51/2/204.abstract
AB 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). Methods: Rest–stress 99mTc 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. Results: 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%). Conclusion: C-SR and C-TPD provide higher diagnostic performance than difference between stress and rest TPD or stress hypoperfusion analysis.