Effects of gender and defect reversibility on detection of coronary disease with an upright and supine cadmium-zinc-telluride camera
- 15 Downloads
Limited data address the roles of gender, perfusion defect reversibility, and imaging position in interpretation of images acquired on an upright/supine cadmium-zinc-telluride (CZT) cardiac imaging system.
Methods and Results
From a consecutive cohort of patients imaged on an upright/supine CZT camera, 260 patients with coronary angiograms were studied. Multivariable models identified gender as a significant effect modifier for imaging variables of CAD. For males, a supine summed stress score (SSS) ≥ 3 provided high accuracy (sensitivity 70.7%, specificity 72.2%), and highest contribution to multivariable models. In females, supine SSS ≥ 2 provided the best cut-off for defect size and severity (sensitivity 90%, specificity 35.9%), but specificity was improved substantially to 53.3% with decrease in sensitivity to 80% by also requiring quantitative identification of perfusion defect reversibility in the supine position. Eight variables, accurate for predicting coronary disease, were more accurate with supine than upright imaging.
Perfusion defect reversibility improved specificity in female patients for detection of coronary disease compared to perfusion defect size and extent alone. Supine images provided superior accuracy for detection of coronary disease compared to upright images.
KeywordsSPECT MPI CAD
Single-photon emission computerized tomography
Summed stress score
- Combined SSS
Combined summed stress score (SSS ≥ 3 both supine and upright, or SSS ≥ 5 in either upright or supine position)
- Supine SSS
Summed stress score in supine position
Summed rest score
Summed difference score
Summed rest percentage
Summed stress percentage
Total quantitative change in defect reversibility in the entire left ventricle
QREV in the supine position
The authors thank Marge Duke for her invaluable assistance with the data management.
None of the above authors have any conflicts of interest.
- 5.Perrin M, Djaballah W, Moulin F, Claudin M, Veran N, Imbert L, et al. Stress-first protocol for myocardial perfusion SPECT imaging with semiconductor cameras: High diagnostic performances with significant reduction in patient radiation doses. Eur J Nucl Med Mol Imaging 2015;42:1004-11.CrossRefGoogle Scholar
- 7.Jameria ZA, Abdallah M, Fernandez-Ulloa M, O’Donnell R, Dwivedi AK, Washburn E, et al. Analysis of stress-only imaging, comparing upright and supine CZT camera acquisition to conventional gamma camera images with and without attenuation correction, with coronary angiography as a reference. J Nucl Cardiol 2018;25:540-9.CrossRefGoogle Scholar