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

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

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.

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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

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Disclosure

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

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Authors and Affiliations

  1. Nuclear Medicine Department, Onassis Cardiac Surgery Center, Zoodochou Pigis 54, Melissia, ZC 15127, Athens, Greece

    Athanasios Katsikis MD, Athanasios Theodorakos MD, Anna Kouzoumi, Elpida Kitziri & Maria Koutelou MD, MSc, PhD

  2. Medical Physics Department, Athens Medical University, Athens, Greece

    Evangelos Georgiou PhD

Authors
  1. Athanasios Katsikis MD
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  2. Athanasios Theodorakos MD
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  3. Anna Kouzoumi
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  4. Elpida Kitziri
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  5. Evangelos Georgiou PhD
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  6. Maria Koutelou MD, MSc, PhD
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Corresponding author

Correspondence to Athanasios Katsikis MD.

Additional information

See related editorial, doi:10.1007/s12350-016-0461-z.

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Katsikis, A., Theodorakos, A., Kouzoumi, A. et al. Fast myocardial perfusion imaging with 99mTc in challenging patients using conventional SPECT cameras. J. Nucl. Cardiol. 24, 1314–1327 (2017). https://doi.org/10.1007/s12350-016-0431-5

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  • DOI: https://doi.org/10.1007/s12350-016-0431-5

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