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Journal of Nuclear Cardiology

, Volume 24, Issue 4, pp 1314–1327 | Cite as

Fast myocardial perfusion imaging with 99mTc in challenging patients using conventional SPECT cameras

  • Athanasios KatsikisEmail author
  • Athanasios Theodorakos
  • Anna Kouzoumi
  • Elpida Kitziri
  • Evangelos Georgiou
  • Maria Koutelou
Original Article

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.

Keywords

Myocardial perfusion imaging fast protocol tetrofosmin diagnostically challenging patients 

Abbreviations

CAD

Coronary artery disease

SSS

Summed stress score

SDS

Summed difference score

SRS

Summed rest score

LVEDV

LV end-diastolic volume

LVESV

LV end-systolic volume

BAA

Bland-Altman analysis

TMD

Total ischemic mass defect

ICC

Intraclass correlation coefficient

QCA

Quantitative coronary angiography

Notes

Disclosure

No relationships with industry or forms of financial support to be disclosed.

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Copyright information

© American Society of Nuclear Cardiology 2016

Authors and Affiliations

  • Athanasios Katsikis
    • 1
    Email author
  • Athanasios Theodorakos
    • 1
  • Anna Kouzoumi
    • 1
  • Elpida Kitziri
    • 1
  • Evangelos Georgiou
    • 2
  • Maria Koutelou
    • 1
  1. 1.Nuclear Medicine DepartmentOnassis Cardiac Surgery CenterAthensGreece
  2. 2.Medical Physics DepartmentAthens Medical UniversityAthensGreece

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