TY - JOUR T1 - Prospective validation of attenuation corrected rest/exercise stress Tc-99m tetrofosmin myocardial perfusion normal database for the CZT SPECT system JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 1711 LP - 1711 VL - 54 IS - supplement 2 AU - James Galt AU - Russell Folks AU - Ernest Garcia AU - Liudmila Verdes AU - Fabio Esteves Y1 - 2013/05/01 UR - http://jnm.snmjournals.org/content/54/supplement_2/1711.abstract N2 - 1711 Objectives To construct and prospectively validate a normal database and abnormality criteria for DNM 530c rest/stress attenuation corrected (AC) Tc-99m tetrofosmin myocardial perfusion SPECT. Methods All patients received a dose of 6 mCi at rest and 20 mCi at stress. Rest images were obtained over 7, 8, or 9 minutes and stress over 5, 6, or 7 minutes depending on chest size. On the same day, low dose CT (average 0.4 mSv) of the patient’s thorax was obtained on a standalone CT scanner using a shallow free breathing protocol. CT images were imported and manually registered with the SPECT images prior to reconstruction (MLEM) with AC using the manufacturer’s software. ECTb software was used for processing and interpretation. Forty patients (mean age 49 ± 11 years, 20 men) with low (<5%) likelihood (LLK) of coronary artery disease (CAD) were used to define the normal count distribution. An expert reader scored a pilot group of 150 patients (mean age 62 ± 12 years, 78 men) using the 17-segment LV model on a 5-point scale (0-4). Optimum criteria for abnormality were determined by ROC curve analysis for each of 7 myocardial segments. Abnormality criteria were prospectively validated in 44 patients (mean age 63 ± 11 years, 27 men) who had coronary angiography within 2 months of the SPECT and in 40 patients (mean age 53 ± 9 years, 14 men) with LLK of CAD. Obstructive CAD was defined as a 70% luminal stenosis in at least one major coronary artery. Results Prospective validation of normal database yielded quantitative sensitivity and specificity of 88% (29/33) and 82% (9/11) for detection of obstructive CAD and a normalcy rate of 98% (39/40). Conclusions Normal database and abnormality criteria for AC rest/exercise stress Tc-99m tetrofosmin myocardial perfusion SPECT protocol have been developed for the DNM 530c. Preliminary results in patients who had coronary angiography suggest that the AC normal database improves quantitative specificity when compared to non-AC SPECT. Research Support This work was supported by GE Healthcare. ER -