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The clinical usefulness of phase analysis in detecting coronary artery disease using dipyridamole thallium-201-gated myocardial perfusion imaging with a cadmium-zinc-telluride camera

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Previous studies have demonstrated left ventricular mechanical dyssynchrony (LVMD) in patients with severe coronary artery disease (CAD) with ≥ 70% stenosis. The aim of this study was to evaluate the clinical usefulness of stress/rest LVMD in the diagnosis of CAD with ≥ 50% stenosis using dipyridamole thallium-201 (Tl-201) myocardial perfusion imaging (MPI) with a cadmium-zinc-telluride camera.

Methods and Results

A total of 476 patients without known CAD who underwent dipyridamole Tl-201 MPI and coronary angiography within 6 months were retrospectively reviewed. LVMD parameters including phase standard deviation and phase histogram bandwidth, phase skewness and phase kurtosis, as well as myocardial perfusion and myocardial stunning were assessed in post-stress and rest MPI. Relationships between the presence of CAD on coronary angiography and single photon emission computerized tomography (SPECT) parameters were evaluated. The presence of perfusion abnormalities was the best diagnostic tool in detecting CAD. Although less left ventricular synchrony was observed post-stress in the CAD group compared to the non-CAD group, no significant dyssynchrony was noted.

Conclusions

The addition of phase analysis to help diagnose CAD in Tl-201-gated SPECT with dipyridamole stress may have limited value in patients with CAD with ≥ 50% stenosis.

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Abbreviations

CAD:

Coronary artery disease

CZT:

Cadmium-zinc-telluride

LVEF:

Left ventricular ejection fraction

LVMD:

Left ventricular mechanical dyssynchrony

MPI:

Myocardial perfusion imaging

PHB:

Phase histogram bandwidth

PSD:

Phase standard deviation

SDS:

Summed difference score

SPECT:

Single photon emission computerized tomography

SSS:

Summed stress score

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Acknowledgements

We thank Ya-Huang Chen, Chia-Wen Lai, Chao-Chun Huang, Po-Wei Li for GSPECT analyses, Chien-Yu Chu for clinical data collection, and the staff of Biotechnology R&D Center, National Taiwan University Hospital, Hsin-Chu Branch for their assistance in statistical analysis.

Disclosure

The authors report no potential conflicts of interest relevant to this article.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, 220, Taiwan

    Wan-Ling Lin MD, Shan-Ying Wang MD, Yu-Chien Shiau MD, PhD & Yen-Wen Wu MD, PhD

  2. Department of Nuclear Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan

    Wan-Ling Lin MD

  3. National Yang-Ming University School of Medicine, Taipei City, Taiwan

    Yen-Wen Wu MD, PhD

  4. Department of Nuclear Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei City, Taiwan

    Yen-Wen Wu MD, PhD

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  1. Wan-Ling Lin MD
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  2. Shan-Ying Wang MD
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Correspondence to Yen-Wen Wu MD, PhD.

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Funding

This study was partially supported by Grants MOST 101-2314-B418-012-MY3, 104-2314-B-418-008 and 105-2325-B-418-001 from the Ministry of Science and Technology of Taiwan, and Far Eastern Memorial Hospital (FEMH 101-2314-B-418-012-MY3, 104-2314-B-418-008; 105-2628-B-418 -002 -MY2). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Lin, WL., Wang, SY., Shiau, YC. et al. The clinical usefulness of phase analysis in detecting coronary artery disease using dipyridamole thallium-201-gated myocardial perfusion imaging with a cadmium-zinc-telluride camera. J. Nucl. Cardiol. 27, 241–250 (2020). https://doi.org/10.1007/s12350-018-1417-2

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  • DOI: https://doi.org/10.1007/s12350-018-1417-2

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