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Comparative accuracy of supine-only and combined supine-prone myocardial perfusion imaging in men

  • Original Article
  • Published:
Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Combined supine-prone myocardial perfusion imaging (CSP MPI) has been shown to reduce attenuation artifact in comparison to supine-only (SU) MPI in mixed-gender populations with varying risk for coronary artery disease (CAD), often where patients served as their own controls. However, there is limited direct comparison of these imaging strategies in men.

Methods

934 male patients underwent CSP or SU MPI. Diagnostic certainty of interpretation was compared. Within the cohort, 116 were referred for left heart catheterization (LHC) to assess for CAD. Sensitivity, specificity, and area under the curve (AUC) were compared with additional analysis based on body mass index (BMI).

Results

597 patients completed the SU protocol and 337 patients completed the CSP protocol. Equivocal studies were seen more frequently in the SU group (13%) than in the CSP group (4%, P < .001). At catheterization, the specificity for CSP MPI of 70% was higher than 40% for SU MPI (P = .032). The CSP AUC (0.80 ± 0.06) was significantly larger than SU AUC (0.57 ± 0.05, P = .004). CSP specificity was significantly higher in obese patients.

Conclusions

CSP MPI increases diagnostic certainty and improves test accuracy for CAD detection in men with CAD risk factors, especially obese patients, compared to SU MPI.

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Abbreviations

AC:

Attenuation correction

BMI:

Body mass index

CABG:

Coronary artery bypass grafting

CAD:

Coronary artery disease

CSP:

Combined supine-prone

EKG:

Electrocardiogram

FFR:

Fractional flow reserve

LHC:

Left heart catheterization

MPI:

Myocardial perfusion imaging

PCI:

Percutaneous coronary intervention

SPECT:

Single photon emission computed tomography

SU:

Supine

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Disclosure

The authors report no conflicts of interest.

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Authors and Affiliations

  1. Malcom Randall VA Medical Center, 1600 SW Archer Road, Gainesville, FL, 32606, USA

    Vicente Taasan MD, Anita Wokhlu MD, Michael V. Taasan MPH, Ajay Mehta MD, Steven Kraft MD, David Winchester MD & David Wymer MD

  2. Lake City VA Medical Center, Lake City, FL, USA

    Vicente Taasan MD, Anita Wokhlu MD, Michael V. Taasan MPH, Ajay Mehta MD, Steven Kraft MD, David Winchester MD & David Wymer MD

  3. University of Florida College of Medicine, Gainesville, FL, USA

    Anita Wokhlu MD, Ajay Mehta MD, Steven Kraft MD, David Winchester MD & David Wymer MD

  4. LeHigh Valley Health Network, Allentown, PA, USA

    Raman S. Dusaj MD

Authors
  1. Vicente Taasan MD
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  2. Anita Wokhlu MD
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  3. Michael V. Taasan MPH
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  4. Raman S. Dusaj MD
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  5. Ajay Mehta MD
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  7. David Winchester MD
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Corresponding author

Correspondence to Vicente Taasan MD.

Additional information

See related editorial, doi:10.1007/s12350-015-0389-8.

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Taasan, V., Wokhlu, A., Taasan, M.V. et al. Comparative accuracy of supine-only and combined supine-prone myocardial perfusion imaging in men. J. Nucl. Cardiol. 23, 1470–1476 (2016). https://doi.org/10.1007/s12350-015-0358-2

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  • DOI: https://doi.org/10.1007/s12350-015-0358-2

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