Original articleCT-based attenuation correction versus prone imaging to decrease equivocal interpretations of rest/stress Tc-99m tetrofosmin SPECT MPI
Section snippets
Patient Population
There were 334 consecutive patients over a period of 7 months who were referred for rest/stress MPI and who underwent stress imaging in the supine and prone position with a dual-head gamma camera equipped with an integrated x-ray transmission system (Infinia/Hawkeye; GE Healthcare). The population of patients was mixed regarding the likelihood of CAD, but there was a large cohort of patients with a low likelihood of CAD referred from the emergency department (Table 1). Patients (n = 10) with
Number of Equivocal Studies
The SSS of equivocal studies ranged from 1 to 8, with a mean (±SD) of 2.93 ± 1.71. The SSS of equivocal studies was 1, 2, or 3 in 68% of patients in both the exercise and adenosine group. The equivocal studies with an SSS of 8 involved 4 segments with a severity score of 2 for each segment and either the entire inferior wall and apex or the entire anterior wall and apex.
Figure 1 illustrates the number of studies classified as normal, equivocal, ischemia, and infarct when different sets of
Discussion
In this study the combination of stress supine SPECT imaging with and without AC decreased the number of equivocal interpretations to a greater extent than the combination of stress supine and stress prone imaging (both without AC), although the combination of all sets of images resulted in the lowest number of equivocal interpretations. This was true for both men and women, although both supine AC imaging and prone imaging were more helpful in men than in women. This was also true for both
Acknowledgment
The authors have indicated they have no financial conflicts of interest.
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