Advertisement

Prognostic impact of myocardial perfusion single photon emission computed tomography in patients with major extracardiac findings by computed tomography for attenuation correction

  • Charline Zadro
  • Noé Roussel
  • Emmanuelle Cassol
  • Pierre Pascal
  • Antoine Petermann
  • Olivier Meyrignac
  • Marion Jaffro
  • Pauline Fournier
  • Maxime Cournot
  • Michel Galinier
  • Didier Carrié
  • Hervé Rousseau
  • Isabelle Berry
  • Olivier Lairez
Original Article
  • 106 Downloads

Abstract

Background

Attenuation correction computed tomography (CT) contributes to an improvement in the diagnostic accuracy of myocardial perfusion imaging (MPI) by single photon emission tomography (SPECT). The aim of this study was to explore the prognosis of patients with major findings by CT according to the results of MPI.

Methods and Results

1506 patients who underwent MPI by SPECT were retrospectively included. Attenuation correction CT images were systematically analyzed for major and minor abnormalities. 830 (55.1%) and 212 (14.1%) patients had minor and major extracardiac findings, respectively. Among patients with major extracardiac findings, the abnormality was previously unknown in 113 (53.3%) patients. 90 (41.9%) had abnormal MPI, 73 (34.4%) had a myocardial infarction scar, 55 (25.9%) had myocardial ischemia, and 38 (17.7%) patients had both myocardial infarction scar and myocardial ischemia. Among the 201 patients available for survival analysis, there were 67 (31.2%) deaths over a follow-up period of 3.2±1.3 years. There was no significant impact on survival arising from MPI, whatever the result. The results were the same among the 103 patients with previously unknown major extracardiac findings.

Conclusion

Extracardiac findings by CT during MPI are frequent. Patients with major extracardiac findings have a poor mid-term outcome, whatever the results of the myocardial perfusion imaging. Extracardiac findings should be systematically checked when attenuation correction CT is performed.

Keywords

Myocardial perfusion imaging single photon emission computed tomography computed tomography extracardiac findings prognosis 

Abbreviations

CT

Computed X-ray tomography

SDS

Summed difference score

SPECT

Single photon emission computed tomography

SRS

Summed rest score

SSS

Summed stress score

Notes

Disclosure

The authors declare they have no conflict of interest related to this article.

Supplementary material

12350_2017_842_MOESM1_ESM.pptx (10.9 mb)
Supplementary material 1 (PPTX 11,142 kb)

References

  1. 1.
    Masood Y, Liu YH, Depuey G, Taillefer R, Araujo LI, Allen S et al (2005) Clinical validation of SPECT attenuation correction using x-ray computed tomography-derived attenuation maps: Multicenter clinical trial with angiographic correlation. J Nucl Cardiol 12:676–686CrossRefPubMedGoogle Scholar
  2. 2.
    Husmann L, Tatsugami F, Aepli U, Herzog BA, Valenta I, Veit-Haibach P et al (2009) Prevalence of noncardiac findings on low dose 64-slice computed tomography used for attenuation correction in myocardial perfusion imaging with SPECT. Int J Cardiovasc Imaging 25:859–865CrossRefPubMedGoogle Scholar
  3. 3.
    Coward J, Lawson R, Kane T, Elias M, Howes A, Birchall J et al (2015) Multicentre analysis of incidental findings on low-resolution CT attenuation correction images: An extended study. Br J Radiol 88:20150555CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Hachamovitch R, Berman DS, Shaw LJ, Kiat H, Cohen I, Cabico JA et al (1998) Incremental prognostic value of myocardial perfusion single photon emission computed tomography for the prediction of cardiac death: differential stratification for risk of cardiac death and myocardial infarction. Circulation 97:535–543CrossRefPubMedGoogle Scholar
  5. 5.
    Verberne HJ, Acampa W, Anagnostopoulos C, Ballinger J, Bengel F, De Bondt P et al (2015) EANM procedural guidelines for radionuclide myocardial perfusion imaging with SPECT and SPECT/CT: 2015 revision. Eur J Nucl Med Mol Imaging 42:1929–1940CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK et al (2002) Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation 105:539–542CrossRefPubMedGoogle Scholar
  7. 7.
    Gaemperli O, Kaufmann PA, Alkadhi H (2014) Cardiac hybrid imaging. Eur J Nucl Med Mol Imaging 41(Suppl 1):S91–S103CrossRefPubMedGoogle Scholar
  8. 8.
    Flor N, Di Leo G, Squarza SA, Tresoldi S, Rulli E, Cornalba G et al (2013) Malignant incidental extracardiac findings on cardiac CT: Systematic review and meta-analysis. AJR Am J Roentgenol 201:555–564CrossRefPubMedGoogle Scholar
  9. 9.
    Coward J, Lawson R, Kane T, Elias M, Howes A, Birchall J et al (2014) Multi-centre analysis of incidental findings on low-resolution CT attenuation correction images. Br J Radiol 87:20130701CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Lindsay AC, Sriharan M, Lazoura O, Sau A, Roughton M, Jabbour RJ et al (2015) Clinical and economic consequences of non-cardiac incidental findings detected on cardiovascular computed tomography performed prior to transcatheter aortic valve implantation (TAVI). Int J Cardiovasc Imaging 12:12Google Scholar
  11. 11.
    Stachon P, Kaier K, Milde S, Pache G, Sorg S, Siepe M et al (2015) Two-year survival of patients screened for transcatheter aortic valve replacement with potentially malignant incidental findings in initial body computed tomography. Eur Heart J Cardiovasc Imaging 16:731–737CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© American Society of Nuclear Cardiology 2017

Authors and Affiliations

  • Charline Zadro
    • 1
    • 2
  • Noé Roussel
    • 1
    • 2
  • Emmanuelle Cassol
    • 2
    • 3
    • 4
  • Pierre Pascal
    • 2
    • 3
  • Antoine Petermann
    • 1
    • 2
  • Olivier Meyrignac
    • 1
    • 2
  • Marion Jaffro
    • 1
    • 2
  • Pauline Fournier
    • 2
    • 6
  • Maxime Cournot
    • 5
  • Michel Galinier
    • 2
    • 4
    • 6
  • Didier Carrié
    • 6
  • Hervé Rousseau
    • 1
    • 2
    • 4
  • Isabelle Berry
    • 2
    • 3
    • 4
  • Olivier Lairez
    • 2
    • 3
    • 4
    • 6
  1. 1.Department of RadiologyToulouse University HospitalToulouseFrance
  2. 2.Cardiac Imaging CenterToulouse University HospitalToulouse Cedex 9France
  3. 3.Department of Nuclear MedicineToulouse University HospitalToulouseFrance
  4. 4.Medical School of RangueilUniversity Paul SabatierToulouseFrance
  5. 5.Department of CardiologyGabriel Martin HospitalSaint-PaulFrance
  6. 6.Department of CardiologyUniversity Hospital of RangueilToulouseFrance

Personalised recommendations