Journal of Nuclear Cardiology

, Volume 11, Issue 3, pp 273–281

Clinical value of attenuation correction in stress-only Tc-99m sestamibi SPECT imaging

  • Gary V. Heller
  • Timothy M. Bateman
  • Lynne L. Johnson
  • S. James Cullom
  • James A. Case
  • James R. Galt
  • Ernest V. Garcia
  • Keith Haddock
  • Kelly L. Moutray
  • Carlos Poston
  • Eli H. Botvinick
  • Matthews B. Fish
  • William P. Follansbee
  • Sean Hayes
  • Ami E. Iskandrian
  • John J. Mahmarian
  • William Vandecker
Article

DOI: 10.1016/j.nuclcard.2004.03.005

Cite this article as:
Heller, G.V., Bateman, T.M., Johnson, L.L. et al. J Nucl Cardiol (2004) 11: 273. doi:10.1016/j.nuclcard.2004.03.005

Abstract

Background

Attenuation artifact remains a substantial limitation to confident interpretation of images and reduces laboratory efficiency by requiring comparison of stress and rest image sets. Attenuation-corrected stress-only imaging has the potential to ameliorate these limitations.

Methods and Results

Ten experienced nuclear cardiologists independently interpreted 90 stress-only electrocardiography (ECG)-gated technetium 99m sestamibi images in a sequential fashion: myocardial perfusion imaging (MPI) alone, MPI plus ECG-gated data, and attenuation-corrected MPI with ECG-gated data. Images were interpreted for diagnostic certainty (normal, probably normal, equivocal, probably abnormal, abnormal, and perceived need for rest imaging). With stress MPI data alone, only 37% of studies were interpreted as definitely normal or abnormal, with a very high perceived need for rest imaging (77%). The addition of gated data did not alter the interpretations. However, attenuation-corrected data significantly increased the number of studies characterized as definitely normal or abnormal (84%, P < 005) and significantly reduced the perceived need for rest imaging (43%, P < .005). These results were confirmed by use of a nonsequential consensus interpretation of three readers.

Conclusion

Attenuation correction applied to studies with stress-only Tc-99m ECG-gated single photon emission computed tomography images significantly increases the ability to interpret studies as definitely normal or abnormal and reduces the need for rest imaging. These findings may improve laboratory efficiency and diagnostic accuracy.

Key Words

Myocardial perfusion imaging attenuation correction single photon emission computed tomography electrocardiography gating 

Copyright information

© American Society of Nuclear Cardiology 2004

Authors and Affiliations

  • Gary V. Heller
    • 1
  • Timothy M. Bateman
    • 2
  • Lynne L. Johnson
    • 3
  • S. James Cullom
    • 2
  • James A. Case
    • 2
  • James R. Galt
    • 4
  • Ernest V. Garcia
    • 4
  • Keith Haddock
    • 5
  • Kelly L. Moutray
    • 2
  • Carlos Poston
    • 5
  • Eli H. Botvinick
    • 6
  • Matthews B. Fish
    • 7
  • William P. Follansbee
    • 8
  • Sean Hayes
    • 9
  • Ami E. Iskandrian
    • 10
  • John J. Mahmarian
    • 11
  • William Vandecker
    • 12
  1. 1.Nuclear Cardiology LaboratoryHartford HospitalHartford
  2. 2.Cardiovascular ConsultantsKansas City
  3. 3.Rhode Island HospitalProvidence
  4. 4.Emory UniversityAtlanta
  5. 5.Mid America Heart InstituteKansas City
  6. 6.University of California at San Francisco Medical CenterSan Francisco
  7. 7.Sacred Heart Medical CenterSpokane
  8. 8.University of PittsburghPittsburgh
  9. 9.Cedars-Sinai Medical CenterLos Angeles
  10. 10.University of Alabama at BirminghamBirmingham
  11. 11.Baylor College Medical CenterHouston
  12. 12.Medical College of PennsylvaniaPhiladelphia

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