Limited incremental diagnostic values of attenuation-noncorrected gating and ungated attenuation correction to rest/stress myocardial perfusion SPECTin patients with an intermediate likelihood of coronary artery disease
Ds. Lee et al., Limited incremental diagnostic values of attenuation-noncorrected gating and ungated attenuation correction to rest/stress myocardial perfusion SPECTin patients with an intermediate likelihood of coronary artery disease, J NUCL MED, 41(5), 2000, pp. 852-859
Citations number
25
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
Either gated myocardial perfusion SPECT or attenuation-corrected SPECT can
be used to improve specificity in the diagnosis of coronary artery disease
(CAD). We investigated whether attenuation-noncorrected gating and ungated
attenuation correction could improve the diagnostic performance of rest/str
ess perfusion SPECT in patients having an intermediate pretest likelihood o
f CAD. Methods: Sixty-eight patients (29 men, 39 women; mean age, 59 +/- 12
y) with coronary artery stenosis greater than or equal to 70% (1 vessel, n
= 13; 2 vessels, n = 18; 3 vessels, n = 8; normal, n = 29) underwent rest
attenuation-corrected Tl-201 SPECT and dipyridamole stress gated attenuatio
n-corrected Tc-99m-methoxyisobutyl isonitrile SPECT with an ADAC vertex cam
era. Three physicians graded the post-test likelihood of CAD for each arter
ial territory using a 5-point scale (1, normal; 2, possibly normal; 3, equi
vocal; 4, possibly abnormal; 5, abnormal). The sensitivity, specificity, an
d areas under receiver-operating-characteristic curves were compared for ea
ch operator by 3 methods: attenuation-noncorrected rest/stress SPECT, gated
poststress SPECT plus attenuation-noncorrected rest/stress SPECT, and atte
nuation-corrected rest/stress SPECT plus gated poststress SPECT plus attenu
ation-noncorrected rest/stress SPECT Results: When higher than grade 3 was
used as the criterion for CAD, no differences in sensitivity and specificit
y were found among the 3 methods for each operator, Areas under receiver-op
erating-characteristic curves for the diagnosis of CAD and stenosis reveale
d no differences for each modality (P > 0.05 for each comparison). Conclusi
on: In patients with an intermediate risk of CAD, viewing attenuation-nonco
rrected gated poststress SPECT and ungated attenuation-corrected rest/stres
s SPECT images did not improve the diagnostic performance for CAD and steno
sis.