PT  - JOURNAL ARTICLE
AU  - Yuan Xu
AU  - Mathews Fish
AU  - Mark Hyun
AU  - Guido Germano
AU  - Daniel Berman
AU  - Piotr Slomka
TI  - Diagnostic value of transient ischemic dilation for coronary artery disease in sestamibi myocardial perfusion SPECT
DP  - 2011 May 01
TA  - Journal of Nuclear Medicine
PG  - 2040--2040
VI  - 52
IP  - supplement 1
4099  - http://jnm.snmjournals.org/content/52/supplement_1/2040.short
4100  - http://jnm.snmjournals.org/content/52/supplement_1/2040.full
SO  - J Nucl Med2011 May 01; 52
AB  - 2040 Objectives Transient ischemic dilation (TID) of the left ventricle in Myocardial Perfusion SPECT (MPS) is a clinically useful marker of severe coronary artery disease (CAD). We aimed to evaluate its diagnostic value for 99mTc-sestamibi rest/stress protocol (Mibi-Mibi), which has not been reported to date. Methods TID ratios were derived from static stress/rest MPS (TID) and gated stress/rest MPS from the end-diastolic phase (gTID) in 564 patients who underwent Mibi-Mibi scans (218 patients with correlating coronary angiography and 346 patients with low likelihood (LLk) of CAD). Scans were classified as severe (≥70% stenosis in proximal left anterior descending artery (pLAD) or left main (LM), or ≥90% in ≥2 vessels), mild to moderate (≥90% stenosis in 1 vessel or ≥70%-90% in ≥1 vessel except pLAD or LM), and normal (<70% stenosis or LLk group). Results The abnormal thresholds were 1.20 for TID and 1.23 for gTID. Both ratios increased with disease severity (P<.0001) (Table). Incidence of abnormal TID increased from 2% in normals (n=416) to > 37% in pts with severe CAD (n=61). The incidence of abnormal TID was higher for high perfusion scores (STPD≥10%) than for the group with normal perfusion (STPD<3%) (27% vs. 6%: P<.0001). The sensitivity for diagnosing the patients with severe CAD trended to improve (TID: 72% vs. 65%: P=0.05, gTID: 70% vs. 65%: P=0.08), while the accuracy was the same if abnormal TID was considered as a marker in addition to STPD. Conclusions TIDs in Mibi-Mibi MPS can be derived from gated or ungated MPS and are useful markers of severe CADTID ratios in severity of coronary artery disease group