Athanasios Katsikis1, Athanasios Theodorakos2, Anna Kouzoumi2, Elpida Kitziri2, Evangelos Georgiou3, Maria Koutelou2. 1. Nuclear Medicine Department, Onassis Cardiac Surgery Center, Zoodochou Pigis 54, Melissia, ZC 15127, Athens, Greece. tkatsikis@gmail.com. 2. Nuclear Medicine Department, Onassis Cardiac Surgery Center, Zoodochou Pigis 54, Melissia, ZC 15127, Athens, Greece. 3. Medical Physics Department, Athens Medical University, Athens, Greece.
Abstract
BACKGROUND: We attempted to validate the performance of a fast myocardial perfusion imaging (MPI) protocol in diagnostically challenging patients. METHODS: 78 patients with ΒΜΙ > 24.9, LVH or three vessels disease underwent two sequential gated-MPI studies. The first at 15 (Early Imaging, EI) and the second at 45 (Late Imaging, LI) minutes post 99mTc-injection, at both stress and rest. Counts over heart (H), liver (Liv) and subdiaphragmatic space (Sub) and image quality, and myocardial perfusion and function parameters were compared between the two protocols. Coronary angiography was performed within 2 months from MPI, and ROC analysis was used to compare the diagnostic accuracy for the detection of ≥50% diameter luminal stenosis. RESULTS: Quality was optimal-good in 93% of EI and 98% of LI studies (P = .12), H/Liv and stress H/Sub ratios were similar, but rest H/Sub ratio was lower in EI (P = .009). SSS [10 (0 to 46) vs 9 (0 to 36), P = .006] and SDS [3 (0 to 35) vs 2 (0 to 34), P = .02] were higher in EI protocol. LVEF, motion and thickening scores did not differ between the two protocols. A highly significant (P < .001) linear relationship with clinically negligible mean differences in Bland-Altman analysis was observed for all perfusion and function-related data. Sensitivity (EI 81%, LI 80%) and specificity (65% for both) did not differ (P = .23) between the two protocols. CONCLUSION: The fast protocol is technically feasible and diagnostically accurate compared to the established protocol in diagnostically challenging patients.
BACKGROUND: We attempted to validate the performance of a fast myocardial perfusion imaging (MPI) protocol in diagnostically challenging patients. METHODS: 78 patients with ΒΜΙ > 24.9, LVH or three vessels disease underwent two sequential gated-MPI studies. The first at 15 (Early Imaging, EI) and the second at 45 (Late Imaging, LI) minutes post 99mTc-injection, at both stress and rest. Counts over heart (H), liver (Liv) and subdiaphragmatic space (Sub) and image quality, and myocardial perfusion and function parameters were compared between the two protocols. Coronary angiography was performed within 2 months from MPI, and ROC analysis was used to compare the diagnostic accuracy for the detection of ≥50% diameter luminal stenosis. RESULTS: Quality was optimal-good in 93% of EI and 98% of LI studies (P = .12), H/Liv and stress H/Sub ratios were similar, but rest H/Sub ratio was lower in EI (P = .009). SSS [10 (0 to 46) vs 9 (0 to 36), P = .006] and SDS [3 (0 to 35) vs 2 (0 to 34), P = .02] were higher in EI protocol. LVEF, motion and thickening scores did not differ between the two protocols. A highly significant (P < .001) linear relationship with clinically negligible mean differences in Bland-Altman analysis was observed for all perfusion and function-related data. Sensitivity (EI 81%, LI 80%) and specificity (65% for both) did not differ (P = .23) between the two protocols. CONCLUSION: The fast protocol is technically feasible and diagnostically accurate compared to the established protocol in diagnostically challenging patients.
Entities:
Keywords:
Myocardial perfusion imaging; diagnostically challenging patients; fast protocol; tetrofosmin
Authors: Manuel D Cerqueira; Neil J Weissman; Vasken Dilsizian; Alice K Jacobs; Sanjiv Kaul; Warren K Laskey; Dudley J Pennell; John A Rumberger; Thomas Ryan; Mario S Verani Journal: J Nucl Cardiol Date: 2002 Mar-Apr Impact factor: 5.952
Authors: I Matsunari; Y Tanishima; J Taki; K Ono; H Nishide; S Fujino; M Matoba; K Ichiyanagi; N Tonami Journal: J Nucl Med Date: 1996-10 Impact factor: 10.057
Authors: Assuero Giorgetti; Massimiliano Rossi; Mario Stanislao; Guido Valle; Pietro Bertolaccini; Alberto Maneschi; Raffaele Giubbini; Maria Luisa De Rimini; Marco Mazzanti; Mario Cappagli; Elisa Milan; Duccio Volterrani; Paolo Marzullo Journal: J Nucl Med Date: 2007-09-14 Impact factor: 10.057
Authors: N Hattori; N Tamaki; I Masuda; Y Taniguchi; H Kitano; T Kudoh; M Inubushi; E Tadamura; Y Magata; K Nakao; J Konishi Journal: Clin Nucl Med Date: 1999-02 Impact factor: 7.794
Authors: Leslee J Shaw; Daniel S Berman; David J Maron; G B John Mancini; Sean W Hayes; Pamela M Hartigan; William S Weintraub; Robert A O'Rourke; Marcin Dada; John A Spertus; Bernard R Chaitman; John Friedman; Piotr Slomka; Gary V Heller; Guido Germano; Gilbert Gosselin; Peter Berger; William J Kostuk; Ronald G Schwartz; Merill Knudtson; Emir Veledar; Eric R Bates; Benjamin McCallister; Koon K Teo; William E Boden Journal: Circulation Date: 2008-02-11 Impact factor: 29.690