Journal of Nuclear Medicine | |
Improved Quantification and Normal Limits for Myocardial Perfusion Stress–Rest Change | |
Daniel S. Berman1  Sean Hayes1  Paul Kavanagh1  Piotr J. Slomka1  Mathews Fish1  Mithun Prasad1  Guido Germano1  James Gerlach1  | |
关键词: SPECT; normal limits; myocardial perfusion stress–rest change; quantification; | |
DOI : 10.2967/jnumed.109.067736 | |
学科分类:医学(综合) | |
来源: Society of Nuclear Medicine | |
【 摘 要 】
We aimed to improve the quantification of myocardial perfusion stress–rest changes in myocardial perfusion SPECT (MPS) studies for the optimal automatic detection of ischemia and coronary artery disease (CAD). Methods: Rest–stress 99mTc MPS studies (997 cases; 651 consecutive cases with correlating angiography and 346 cases with less than 5% likelihood (low likelihood [LLK]) of CAD) were analyzed. Normal limits for stress–rest changes were derived from additional LLK patients (40 women, 40 men). We computed the global stress–rest change (C-SR) by integrating direct stress–rest changes for each polar map pixel. Additionally, stress–rest change and total perfusion deficit (TPD) at stress were combined in 1 variable (C-TPD) for the optimal detection of CAD. Results: The area under the receiver-operating-characteristic curve (AUC) for C-SR (0.92) was larger than that for stress TPD–rest TPD (0.88) for the identification of stenosis of 70% or more (P < 0.0001). AUC (0.94) and sensitivity (90%) for C-TPD were higher than those for stress TPD (0.91 and 83%, respectively) (P < 0.0001), whereas specificity remained the same (81%). Conclusion: C-SR and C-TPD provide higher diagnostic performance than difference between stress and rest TPD or stress hypoperfusion analysis.
【 授权许可】
Unknown
【 预 览 】
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RO201912010197657ZK.pdf | 1356KB | download |