Original articleQuantitative Tc-99m sestamibi attenuation-corrected SPECT: development and multicenter trial validation of myocardial perfusion stress gender-independent normal database in an obese population☆
Section snippets
Population
Two hundred seven patients comprised the study population. These patients underwent ECG-gated 1-day rest-stress technetium 99m sestamibi simultaneous transmission/emission attenuation correction (VantagePro/ExSPECT II; Philips Laboratories, Milpitas, Calif) SPECT myocardial perfusion studies. The studies were obtained from four institutions: Cardiovascular Consultants–Mid America Heart Institute (Kansas City, Mo), Hartford Hospital (Hartford, Conn), Rhode Island Hospital (Providence, RI), and
Distribution of normal limits
The comparisons of the uncorrected and AC normal perfusion distributions in men and women by use of Tc-99m sestamibi stress are shown in Figure 1. The uncorrected normal distributions yielded 7 out of 20 segments that showed significant differences between genders at a P < .001 level. The AC normal distributions showed no significant differences between genders at a P < .001 level (Figure 2).
Determination of criteria for stress abnormality
The determined criteria for stress abnormality expressed in terms of SDs below the mean normal limit
Discussion
This study was performed to develop and validate the stress normal limits and criteria for abnormality for quantitative same-day rest-stress Tc-99m sestamibi AC SPECT studies by use of a gender-independent normal database. Validation was performed with coronary arteriography used as a gold standard to determine the accuracy of this AC quantitative analysis for the detection and localization of CAD in a multicenter prospective obese population. These results were compared with results from the
Acknowledgements
Some of the authors (E.V.G., T.M.B., R.D.F., S.J.C., J.R.G., and J.A.C.) receive royalties from the sale of the application software (ExSPECT II) related to the research described in this article. In addition, some of the authors (E.V.G. and R.D.F.) receive royalties from the sale of the Emory Cardiac Toolbox used for quantification comparisons in this study. The terms of this arrangement have been reviewed and approved by Emory University in accordance with its conflict-of-interest policy.
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Dr Grossman was funded in part by a grant from CAPES–Brazilian Research Agency through the Cardiovascular Science and Cardiology Graduate Program from the Federal University of Rio Grande do Sul, Brazil.