Journal of Nuclear Cardiology

, Volume 20, Issue 1, pp 53–63 | Cite as

Gender differences in the diagnostic accuracy of SPECT myocardial perfusion imaging: A bivariate meta-analysis

  • Aline Iskandar
  • Brendan Limone
  • Matthew W. Parker
  • Andrew Perugini
  • Hyejin Kim
  • Charles Jones
  • Brian Calamari
  • Craig I. Coleman
  • Gary V. Heller
Original Article



It remains controversial whether the diagnostic accuracy of single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI) is different in men as compared to women. We performed a meta-analysis to investigate gender differences of SPECT MPI for the diagnosis of CAD (≥50% stenosis).


Two investigators independently performed a systematic review of the MEDLINE and EMBASE databases from inception through January 2012 for English-language studies determining the diagnostic accuracy of SPECT MPI. We included prospective studies that compared SPECT MPI with conventional coronary angiography which provided sufficient data to calculate gender-specific true and false positives and negatives. Data from studies evaluating <20 patients of one gender were excluded. Bivariate meta-analysis was used to create summary receiver operating curves.


Twenty-six studies met inclusion criteria, representing 1,148 women and 1,142 men. Bivariate meta-analysis yielded a mean sensitivity and specificity of 84.2% (95% confidence interval [CI] 78.7%-88.6%) and 78.7% (CI 70.0%-85.3%) for SPECT MPI in women and 89.1% (CI 84.0%-92.7%) and 71.2% (CI 60.8%-79.8%) for SPECT MPI in men. There was no significant difference in the sensitivity (P = .15) or specificity (P = .23) between male and female subjects.


In a bivariate meta-analysis of the available literature, the diagnostic accuracy of SPECT MPI is similar for both men and women.


Myocardial perfusion imaging: SPECT diagnostic and prognostic application SPECT 



Dr Heller serves on the Scientific Advisory Board of Lantheus Medical Imaging. The remaining authors have no disclosures relevant to this project.

Supplementary material

12350_2012_9646_MOESM1_ESM.docx (52 kb)
Supplementary material 1 (DOCX 52 kb)


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Copyright information

© American Society of Nuclear Cardiology 2012

Authors and Affiliations

  • Aline Iskandar
    • 1
    • 3
  • Brendan Limone
    • 2
  • Matthew W. Parker
    • 1
    • 3
  • Andrew Perugini
    • 2
  • Hyejin Kim
    • 2
  • Charles Jones
    • 2
  • Brian Calamari
    • 2
  • Craig I. Coleman
    • 2
    • 4
  • Gary V. Heller
    • 1
    • 3
  1. 1.Department of MedicineUniversity of Connecticut School of MedicineFarmingtonUSA
  2. 2.University of Connecticut School of PharmacyStorrsUSA
  3. 3.Division of CardiologyHenry Low Heart Center, Hartford HospitalHartfordUSA
  4. 4.Hartford Hospital Evidence Based Practice CenterHartfordUSA

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