Background: The purpose of this study is to assess diagnostic performance of the current quantification packages using Western normal databases in detecting coronary artery disease in Chinese population.
Methods: Seventy-five patients who underwent rest/stress myocardial perfusion SPECT and coronary angiography (CAG) were enrolled. Emory Cardiac Toolbox (ECTb) and Quantitative Perfusion SPECT (QPS) with its standard (QPS-standard) and simplified (QPS-simplified) methods were used to quantify these studies. A preliminary Chinese normal database was created from 80 normal subjects (QPS-simplified-Chinese). Receiver operator characteristic (ROC) was used to assess the accuracy of the four normal databases in detecting >or=50% or >or=70% stenosis given by CAG.
Results: The enrolled cohorts had lower body mass index (BMI) and smaller heart size than Western population. The areas under ROC curve of ECTb, QPS-standard, and QPS-simplified were significantly lower than QPS-simplified-Chinese in detecting >or=50% stenosis, but not in detecting >or=70% stenosis. Diagnostic accuracy was much lower in the RCA and LCX territory.
Conclusion: Chinese normal database is needed for accurately applying these quantification methods to Chinese population, especially for detecting moderate defects in regions with relatively greater attenuation impact. An alternative approach could be modification of the existing Western normal databases for low-BMI and/or small-heart subjects.