| Quantitative upright-supine high-speed SPECT myocardial perfusion imaging for detection of coronary artery disease: correlation with invasive coronary angiography. | |
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MedLine Citation:
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PMID: 20956478 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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METHODS: We studied 142 patients undergoing upright and supine HS-SPECT, including 56 consecutive patients (63% men; mean age ± SD, 64 ± 13 y; 45% exercise stress) without known CAD who underwent diagnostic ICA within 6 mo of HS-SPECT and 86 consecutive patients with a low likelihood of CAD. Reference limits for upright and supine HS-SPECT were created from studies of patients with a low likelihood of CAD. Automated software adopted from supine-prone analysis was used to quantify the severity and extent of perfusion abnormality and was expressed as total perfusion deficit (TPD). TPD was obtained for upright (U-TPD), supine (S-TPD), and combined upright-supine acquisitions (C-TPD). Stress U-TPD ≥ 5%, S-TPD ≥ 5%, and C-TPD ≥ 3% myocardium were considered abnormal for per-patient analysis, and U-TPD, S-TPD, and C-TPD ≥ 2% in each coronary artery territory were considered abnormal for per-vessel analysis. RESULTS: On a per-patient basis, the sensitivity was 91%, 88%, and 94% for U-TPD, S-TPD, and C-TPD, respectively, and specificity was 59%, 73%, and 86% for U-TPD, S-TPD, and C-TPD, respectively. C-TPD had a larger area under the receiver-operating-characteristic curve than U-TPD or S-TPD for identification of stenosis ≥ 70% (0.94 vs. 0.88 and 0.89, P < 0.05 and not significant, respectively). On a per-vessel basis, the sensitivity was 67%, 66%, and 69% for U-TPD, S-TPD, and C-TPD, respectively, and specificity was 91%, 94%, and 97% for U-TPD, S-TPD, and C-TPD, respectively (P = 0.02 for specificity U-TPD vs. C-TPD). CONCLUSION: In this first comparison of HS-SPECT with ICA, new automated quantification of combined upright and supine HS-SPECT shows high diagnostic accuracy for detecting clinically significant CAD, with findings comparable to those reported using conventional SPECT. |
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Authors:
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Ryo Nakazato; Balaji K Tamarappoo; Xingping Kang; Arik Wolak; Faith Kite; Sean W Hayes; Louise E J Thomson; John D Friedman; Daniel S Berman; Piotr J Slomka |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2010-10-18 |
Journal Detail:
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Title: Journal of nuclear medicine : official publication, Society of Nuclear Medicine Volume: 51 ISSN: 1535-5667 ISO Abbreviation: J. Nucl. Med. Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-05 Completed Date: 2010-12-15 Revised Date: 2011-08-01 |
Medline Journal Info:
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Nlm Unique ID: 0217410 Medline TA: J Nucl Med Country: United States |
Other Details:
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Languages: eng Pagination: 1724-31 Citation Subset: IM |
Affiliation:
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Division of Nuclear Medicine, Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Coronary Angiography* Coronary Artery Disease / physiopathology, radiography*, radionuclide imaging* Female Hemodynamics Humans Male Middle Aged Myocardial Perfusion Imaging / methods*, standards Posture* ROC Curve Reference Values Retrospective Studies Sensitivity and Specificity Supine Position Time Factors Tomography, Emission-Computed, Single-Photon / methods*, standards |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL089765-01/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
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