Tali Sharir1, Marina Pinskiy2, Abraham Pardes2, Arik Rochman2, Vitali Prokhorov2, Gil Kovalski3, Konstantine Merzon2, Andrzej Bojko2, Boris Brodkin2,4,5. 1. Department of Nuclear Cardiology, Assuta Medical Centers, 96 Igal Alon, C Building, 67891, Tel Aviv, Israel. tsharir@gmail.com. 2. Department of Nuclear Cardiology, Assuta Medical Centers, 96 Igal Alon, C Building, 67891, Tel Aviv, Israel. 3. General Electric Healthcare, Haifa, Israel. 4. Department of Cardiology, Barzilai Medical Center, Ashkelon, Israel. 5. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel.
Abstract
BACKGROUND: Previous studies have demonstrated accurate diagnosis of reduced dose myocardial perfusion imaging (MPI) using Cadmium-Zinc-Telluride (CZT) technology. We compared the diagnostic performances of very low stress-dose (<2 mSv) with standard-dose stress-first, quantitative MPI using a CZT camera. METHODS: Patients without known coronary artery- disease who underwent a stress-first Tc-99 m sestamibi CZT-MPI and invasive coronary angiography (ICA), and low-risk patients without ICA were included. A stress-rest standard-dose (10/30 mCi) MPI and a low-dose (5/15 mCi) MPI were compared. Normal limits for quantification were developed from 40 (20 males) low-risk patients, and total perfusion deficit (TPD) was derived. RESULTS: 208 patients who underwent MPI and ICA, and 76 low-risk patients were included. Of these, 128 had a standard-dose MPI and 156 had a low-dose MPI. Stress-doses in low-dose and standard-dose groups were 5.9 ± 1.2 vs 10.2 ± 0.5 mCi (1.7 ± 0.3 vs 3.0 ± 0.1 mSv), respectively, P < 0.001, and stress-rest effective radiation was 6.9 ± 1.1 vs 11.7 ± 0.4 mSv, respectively, P < 0.001. Sensitivity, specificity, and accuracy values in the low-dose and standard-dose groups were 86.1%, 76.6%, and 81.4%; and 90.6%, 78.1%, and 84.4%, respectively, P = ns. Using TPD prone, specificity values were 84.9% and 80.3%, respectively, P = ns. CONCLUSION: One-day stress-first MPI with 50% radiation reduction and a very low stress-dose (<2 mSv) using CZT technology and quantitative supine and prone analysis provided a high diagnostic value, similar to standard-dose MPI.
BACKGROUND: Previous studies have demonstrated accurate diagnosis of reduced dose myocardial perfusion imaging (MPI) using Cadmium-Zinc-Telluride (CZT) technology. We compared the diagnostic performances of very low stress-dose (<2 mSv) with standard-dose stress-first, quantitative MPI using a CZT camera. METHODS:Patients without known coronary artery- disease who underwent a stress-first Tc-99 m sestamibi CZT-MPI and invasive coronary angiography (ICA), and low-risk patients without ICA were included. A stress-rest standard-dose (10/30 mCi) MPI and a low-dose (5/15 mCi) MPI were compared. Normal limits for quantification were developed from 40 (20 males) low-risk patients, and total perfusion deficit (TPD) was derived. RESULTS: 208 patients who underwent MPI and ICA, and 76 low-risk patients were included. Of these, 128 had a standard-dose MPI and 156 had a low-dose MPI. Stress-doses in low-dose and standard-dose groups were 5.9 ± 1.2 vs 10.2 ± 0.5 mCi (1.7 ± 0.3 vs 3.0 ± 0.1 mSv), respectively, P < 0.001, and stress-rest effective radiation was 6.9 ± 1.1 vs 11.7 ± 0.4 mSv, respectively, P < 0.001. Sensitivity, specificity, and accuracy values in the low-dose and standard-dose groups were 86.1%, 76.6%, and 81.4%; and 90.6%, 78.1%, and 84.4%, respectively, P = ns. Using TPD prone, specificity values were 84.9% and 80.3%, respectively, P = ns. CONCLUSION: One-day stress-first MPI with 50% radiation reduction and a very low stress-dose (<2 mSv) using CZT technology and quantitative supine and prone analysis provided a high diagnostic value, similar to standard-dose MPI.
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