Document Detail

Clinical value of stress-only Tc-99m SPECT imaging: Importance of attenuation correction.
MedLine Citation:
PMID:  23188624     Owner:  NLM     Status:  Publisher    
BACKGROUND: In selected patients, stress-only SPECT imaging has been proposed as an alternative to rest-stress SPECT imaging to improve laboratory efficiency and reduce radiation exposure. The impact of attenuation correction (AC) upon interpretation, post-test patient management and cardiac risk stratification in relation to stress-only imaging is not well understood. OBJECTIVES: The purpose of this study was to determine the clinical value for laboratory throughput and predicting outcomes of normal and abnormal stress-only SPECT imaging with AC in a consecutive series of clinically referred patients. METHODS: A retrospective analysis of 1,383 consecutive patients who were scheduled for stress-only SPECT imaging for symptom assessment of suspected myocardial ischemia was performed. All images had been interpreted and categorized using the standard 17-segment model without AC followed by AC. Follow-up data for 2.1 ± 1.3 years after SPECT imaging for the occurrence of cardiac events (non-fatal MI, cardiac death, and cardiac revascularization) previously collected by routine methods were reviewed. RESULTS: Non-AC SPECT image interpretation revealed that 58% (802/1383) of patients had abnormal stress images. AC image interpretation of the abnormal non-AC images re-classified 83% (666/802) of these as normal. Among patients with abnormal stress images after AC (136/1383), 63% (86/136) returned for additional rest scans, while the remaining 37% (50/136) were clinically managed without further rest images. The incidence of cardiac death or non-fatal MI was very low in patients with normal stress-only scans (0.7%). CONCLUSION: A strategy of stress-only imaging with AC in symptomatic patients is an efficient method which appropriately identifies at risk and low-risk patients yielding a low percentage requiring rest imaging. Clinical decisions can be made based on abnormal stress-only imaging without further rest imaging if clinically appropriate.
Shishir Mathur; Gary V Heller; Timothy M Bateman; Richard Ruffin; Arshad Yekta; Deborah Katten; Nitya Alluri; Alan W Ahlberg
Related Documents :
17012154 - Advanced visualization platform for surgical operating room coordination: distributed v...
8885344 - A prospective randomized experimental evaluation of three-dimensional imaging in laparo...
23188624 - Clinical value of stress-only tc-99m spect imaging: importance of attenuation correction.
15709664 - Brain shift estimation in image-guided neurosurgery using 3-d ultrasound.
24111814 - Array tomography.
10358264 - Pediatric adolescent gynecologic imaging: precocious puberty and hormone-producing neop...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-28
Journal Detail:
Title:  Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology     Volume:  -     ISSN:  1532-6551     ISO Abbreviation:  J Nucl Cardiol     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423534     Medline TA:  J Nucl Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Nuclear Cardiology Laboratory, Division of Cardiology, Henry Low Heart Center, Hartford Hospital, 80 Seymour Street, Hartford, CT, 06102, USA,
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Potential Roles for Infectious Agents in the Pathophysiology of Primary Biliary Cirrhosis: What's Ne...
Next Document:  Regadenoson pharmacologic rubidium-82 PET: A comparison of quantitative perfusion and function to di...