BACKGROUND: In order to evaluate the diagnostic efficacy of the 1-day separate acquisition dual-isotope single-photon emission computed tomography (SPECT) protocol, using 201Tl for the rest and 99mTc-tetrofosmin for the stress images, a consecutive series of patients with suspected or known coronary artery disease (CAD) was studied that also underwent coronary angiography. METHODS: The results of myocardial SPECT, using a semi-quantitative visual analysis, were acquired in 123 patients and compared with the results of coronary angiography. Sensitivity and specificity were calculated, using thresholds of > or = 50 and > or = 70% stenosis. As an alternative for specificity, the normalcy rate was determined in a separate group of 87 patients with a < 5% pre-test likelihood of CAD. RESULTS: The prevalence of CAD using > or =50 and > or = 70% stenosis was 88 and 78%, respectively. The sensitivity for detection of patients with > or = 50 and > or = 70% stenosis was 94 and 97%, respectively while specificity was 62 and 59%, respectively. The high rate of false positive perfusion defects resulting in a low specificity could be explained by specific clinical issues. However, the routine assessment with additional clinical and electrocardiographic data resulted in a correct interpretation of most of the false positive perfusion defects. The positive predictive value was 92 and 85% and the negative predictive value 46 and 77%, using thresholds of > or = 50 and > or = 70% stenosis, respectively. The normalcy rate was 91%. CONCLUSION: The one-day separate acquisition rest 201Tl/stress 99mTc-tetrofosmin SPECT protocol is an efficient procedure for myocardial perfusion scintigraphy with high sensitivity for detection of CAD. Specific clinical issues caused a low value for specificity. Therefore, clinical information and knowledge of the electrocardiogram is essential for a correct interpretation of SPECT images.
BACKGROUND: In order to evaluate the diagnostic efficacy of the 1-day separate acquisition dual-isotope single-photon emission computed tomography (SPECT) protocol, using 201Tl for the rest and 99mTc-tetrofosmin for the stress images, a consecutive series of patients with suspected or known coronary artery disease (CAD) was studied that also underwent coronary angiography. METHODS: The results of myocardial SPECT, using a semi-quantitative visual analysis, were acquired in 123 patients and compared with the results of coronary angiography. Sensitivity and specificity were calculated, using thresholds of > or = 50 and > or = 70% stenosis. As an alternative for specificity, the normalcy rate was determined in a separate group of 87 patients with a < 5% pre-test likelihood of CAD. RESULTS: The prevalence of CAD using > or =50 and > or = 70% stenosis was 88 and 78%, respectively. The sensitivity for detection of patients with > or = 50 and > or = 70% stenosis was 94 and 97%, respectively while specificity was 62 and 59%, respectively. The high rate of false positive perfusion defects resulting in a low specificity could be explained by specific clinical issues. However, the routine assessment with additional clinical and electrocardiographic data resulted in a correct interpretation of most of the false positive perfusion defects. The positive predictive value was 92 and 85% and the negative predictive value 46 and 77%, using thresholds of > or = 50 and > or = 70% stenosis, respectively. The normalcy rate was 91%. CONCLUSION: The one-day separate acquisition rest 201Tl/stress 99mTc-tetrofosmin SPECT protocol is an efficient procedure for myocardial perfusion scintigraphy with high sensitivity for detection of CAD. Specific clinical issues caused a low value for specificity. Therefore, clinical information and knowledge of the electrocardiogram is essential for a correct interpretation of SPECT images.
Authors: J K Kahn; I McGhie; M S Akers; M N Sills; T L Faber; P V Kulkarni; J T Willerson; J R Corbett Journal: Circulation Date: 1989-06 Impact factor: 29.690
Authors: R G Groutars; J F Verzijlbergen; A J Muller; C A Ascoop; M M Tiel-van Buul; A H Zwinderman; N M van Hemel; E E van der Wall Journal: J Nucl Cardiol Date: 2000 Jul-Aug Impact factor: 5.952
Authors: D S Berman; H Kiat; J D Friedman; F P Wang; K van Train; L Matzer; J Maddahi; G Germano Journal: J Am Coll Cardiol Date: 1993-11-01 Impact factor: 24.094
Authors: Jeroen Schaap; Robert M Kauling; S Matthijs Boekholdt; Martijn C Post; Jan A Van der Heyden; Thom L de Kroon; H Wouter van Es; Benno J W M Rensing; J Fred Verzijlbergen Journal: Int J Cardiovasc Imaging Date: 2012-08-18 Impact factor: 2.357