| Combined quantitative analysis of attenuation corrected and non-corrected myocardial perfusion SPECT: Method development and clinical validation. | |
| | |
MedLine Citation:
|
PMID: 20387137 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Attenuation corrected myocardial perfusion SPECT (AC-MPS) has been demonstrated to improve the specificity of detecting coronary artery disease (CAD) by visual analysis which utilizes both non-corrected (NC) and AC data. However, the combined automated quantification of NC and AC-MPS has not been previously described. We aimed to develop a combined quantitative analysis from AC and NC data to improve the accuracy of automated detection of CAD from AC-MPS. METHODS: Stress total perfusion deficit (TPD) values were generated by standard analysis for NC (NC-TPD), AC (AC-TPD) and by combined NC-AC analysis (NA-TPD), in which the hypoperfusion severity in each polar map location was defined as the average of AC and NC severity computed by comparison with separate AC and NC normal limits. Ischemic TPD was also calculated as the difference between stress TPD and rest TPD for each measure. Stress/rest Tc-99m sestamibi MPS studies in 650 patients with correlating coronary angiography and in 345 patients with a low-likelihood (LLk) of CAD were used to assess diagnostic performance of combined NC-AC analysis. RESULTS: NA-TPD had a higher receiver-operator-characteristic area under the curve (ROC-AUC) (0.87) than NC-TPD (0.85; P < .01) or AC-TPD (0.85; P < .01) for detection of stenosis >or=70% in angiographic group. It also had higher specificity (75%) vs NC-TPD (65%; P < .0001), or AC-TPD (70%; P = .016). In LLk group, the normalcy rate of NA-TPD (95%) was higher than for NC-TPD (90%; P < .01) and similar to AC-TPD (94%; P = NS). NA-TPD had higher ROC-AUC than that for 17-segment expert visual scoring of stress scans in angiographic group (0.84; P = .01), comparable accuracy (81%) and similar normalcy rates (95% vs 97%; P = NS). Ischemic TPD by combined NC-AC analysis had higher ROC-AUC than that for any ischemic measure. Similar to stress NA-TPD, it also obtained the similar performance results as compared with ischemic TPD based on NC or AC and higher sensitivity (89% vs 85%; P = .0295) as compared with ischemic visual score in angiographic group. CONCLUSION: Combined NC-AC MPS quantification using either stress or ischemic TPD shows significant improvements for ROC-AUC and specificity of MPS in the detection of CAD compared with standard NC-MPS or AC-MPS and comparable performance to expert visual scoring. This technique may lead to an enhancement in a fully automated quantification for the perfusion analysis by AC-MPS. |
| | |
Authors:
|
Yuan Xu; Mathews Fish; James Gerlach; Mark Lemley; Daniel S Berman; Guido Germano; Piotr J Slomka |
Related Documents
:
|
14970107 - Serum amyloid a as a predictor of coronary artery disease and cardiovascular outcome in... 18808367 - Predictive value of the decrease in circulating dendritic cell precursors in stable cor... 3578047 - Pericatheterization risk factors in left main coronary artery stenosis. 17719317 - Usefulness of detectable levels of troponin, below the 99th percentile of the normal ra... 1756047 - Adenosine cardioplegia: reducing reperfusion injury of the ischaemic myocardium? 8498307 - Effects of intravenous magnesium sulfate on arrhythmias in patients with congestive hea... |
Publication Detail:
|
Type: Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural; Validation Studies Date: 2010-04-14 |
Journal Detail:
|
Title: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology Volume: 17 ISSN: 1532-6551 ISO Abbreviation: J Nucl Cardiol Publication Date: 2010 Aug |
Date Detail:
|
Created Date: 2010-07-20 Completed Date: 2010-11-30 Revised Date: 2011-08-03 |
Medline Journal Info:
|
Nlm Unique ID: 9423534 Medline TA: J Nucl Cardiol Country: United States |
Other Details:
|
Languages: eng Pagination: 591-9 Citation Subset: IM |
Affiliation:
|
Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Taper #A047, Los Angeles, CA 90048, USA. yuan.xu@cshs.org |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Artifacts* Coronary Artery Disease / diagnosis* Exercise Test Female Humans Image Enhancement / methods* Image Interpretation, Computer-Assisted / methods* Male Middle Aged Myocardial Perfusion Imaging / methods* Reproducibility of Results Sensitivity and Specificity Subtraction Technique* Tomography, Emission-Computed, Single-Photon / methods* |
| Grant Support | |
ID/Acronym/Agency:
|
R01 HL089765-03/HL/NHLBI NIH HHS; R01 HL089765-05/HL/NHLBI NIH HHS; R0HL089765-01/HL/NHLBI NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Intra- and inter-operator repeatability of myocardial blood flow and myocardial flow reserve measure...
Next Document: RNA Modifications: A Mechanism that Modulates Gene Expression.