Document Detail

Direct quantification of left ventricular motion and thickening changes using rest-stress myocardial perfusion SPECT.
MedLine Citation:
PMID:  22872739     Owner:  NLM     Status:  MEDLINE    
METHODS: Endocardial surfaces at the end-diastolic and end-systolic frames for rest-stress studies were registered automatically to each other by matching ventricular surfaces. Myocardial MTCs were computed, and normal limits of change were determined as the mean and SD for each polar sample. Normal limits were used to quantify the MTCs for each map, and the accumulated sample values were used for abnormality assessments in segmental regions. A hybrid method was devised by combining the total perfusion deficit (TPD) and MTC for each vessel territory. Normal limits were obtained from 100 subjects with low likelihood of coronary artery disease. For validation, 623 subjects with correlating invasive angiography were studied. All subjects underwent a rest-stress (99m)Tc-sestamibi exercise or adenosine test and coronary angiography within 3 months of myocardial perfusion SPECT. All MTC and TPD measurements were derived automatically. The diagnostic accuracy for detection of coronary artery disease for MTC plus TPD was compared with TPD alone.
RESULTS: Segmental normal values were between -1.3 and -4.1 mm for motion change and between -30.1% and -9.8% for thickening change. MTC combined with TPD achieved 61% sensitivity for 3-vessel-disease (3VD), 63% for 2-vessel-disease (2VD), and 90% for 1-vessel-disease (1VD) detection, compared with 32% for 3VD (P < 0.0001), 53% for 2VD (P < 0.001), and 90% for 1VD (P = 1.0) detection using the TPD-alone method. The specificity for the combined method was 71% for 3VD, 72% for 2VD, and 47% for 1VD detection versus 90% for 3VD (P < 0.0001), 80% for 2VD (P < 0.001), and 50% for 1VD detection (P = 0.0625) for the TPD-alone method. The accuracy of 3VD detection by MTC plus TPD was higher (69%) than the accuracy of TPD plus change in ejection fraction (63%) (P < 0.004).
CONCLUSION: We established normal limits and a novel method for computation of regional functional changes between the rest and poststress studies. Compared with TPD alone, the combination of TPD with MTC improved the sensitivity for the detection of 3VD and 2VD.
Shahryar Karimi-Ashtiani; Reza Arsanjani; Mathews Fish; Paul Kavanagh; Guido Germano; Daniel Berman; Piotr Slomka
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-08-07
Journal Detail:
Title:  Journal of nuclear medicine : official publication, Society of Nuclear Medicine     Volume:  53     ISSN:  1535-5667     ISO Abbreviation:  J. Nucl. Med.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-07     Completed Date:  2012-11-13     Revised Date:  2013-09-03    
Medline Journal Info:
Nlm Unique ID:  0217410     Medline TA:  J Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1392-400     Citation Subset:  IM    
Department of Imaging and Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
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MeSH Terms
Heart Ventricles / anatomy & histology,  radionuclide imaging*
Image Processing, Computer-Assisted
Middle Aged
Myocardial Perfusion Imaging / methods*
Retrospective Studies
Stress, Physiological*
Tomography, Emission-Computed, Single-Photon / methods*
Ventricular Function, Left*
Grant Support

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

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