Document Detail

Improved quantification and normal limits for myocardial perfusion stress-rest change.
MedLine Citation:
PMID:  20124046     Owner:  NLM     Status:  MEDLINE    
METHODS: Rest-stress (99m)Tc 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.
Mithun Prasad; Piotr J Slomka; Mathews Fish; Paul Kavanagh; James Gerlach; Sean Hayes; Daniel S Berman; Guido Germano
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Validation Studies    
Journal Detail:
Title:  Journal of nuclear medicine : official publication, Society of Nuclear Medicine     Volume:  51     ISSN:  1535-5667     ISO Abbreviation:  J. Nucl. Med.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-03     Completed Date:  2010-03-03     Revised Date:  2013-05-31    
Medline Journal Info:
Nlm Unique ID:  0217410     Medline TA:  J Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  204-9     Citation Subset:  IM    
Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, California, USA.
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MeSH Terms
Coronary Angiography
Coronary Artery Disease / radiography,  radionuclide imaging*
Exercise Test / statistics & numerical data*
Middle Aged
Myocardial Perfusion Imaging / statistics & numerical data*
Radiopharmaceuticals / diagnostic use
Reference Values
Retrospective Studies
Technetium Tc 99m Sestamibi / diagnostic use
Tomography, Emission-Computed, Single-Photon / statistics & numerical data*
Grant Support
R01 HL089765-03/HL/NHLBI NIH HHS; R01 HL089765-05/HL/NHLBI NIH HHS; R0HL089765-01/HL/NHLBI NIH HHS
Reg. No./Substance:
0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi

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