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Quantitative Tc-99m sestamibi attenuation-corrected SPECT: Development and multicenter trial validation of myocardial perfusion stress gender-independent normal database in an obese population

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

A gender-independent stress normal database and criteria for abnormality for attenuation-corrected rest-stress technetium 99m sestamibi same-day myocardial perfusion imaging were developed by evaluation of 112 patients, validated against an obese population of 95 patients from four different clinical sites, and compared with conventional gender-matched database quantification of non-attenuation-corrected studies.

Methods and Results

These 95 validation patients (63 men) were used for prospective quantitative evaluation (mean weight, 213 ± 57 lb; mean body mass index, 32 ± 9 kg/m2). This group included 21 patients (12 men) with a lower than 5% likelihood of coronary artery disease (mean weight, 226 ± 72 lb; mean body mass index, 34 ± 13 kg/m2) and 74 who underwent cardiac catheterization within 2 months (35 with normal coronaries or coronary lesions <70%). These studies were processed twice, once by use of conventional reconstruction and genderspecific database quantification and a second time by use of attenuation correction and a single gender-independent attenuation-corrected normal database. The attenuation-corrected normal database and criteria for abnormality were developed by evaluation of 48 and 78 patients, respectively. No statistically significant differences were found when comparing attenuationcorrected perfusion distributions of normal men and women, whereas significant differences were found in the same uncorrected studies. Compared with quantitative analysis of the uncorrected studies, quantitative analysis of the attenuation-corrected studies by use of a gender-independent normal database demonstrated a significant improvement in normalcy rate (90% vs 52%, P =.006) and specificity (57% vs 29%, P = 015) in this obese population at no significant loss in sensitivity (90% vs 97%, P = not significant).

Conclusion

Attenuation-corrected studies can be quantified with a single gender-independent normal database and a single criterion for abnormality without loss of sensitivity and with significantly better specificity and normalcy rate.

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Authors and Affiliations

  1. Emory University Hospital, Room E163, 1364 Clifton Rd, NE, 30322, Atlanta, GA

    Gabriel B. Grossman, Ernest V. Garcia, Russell D. Folks, James R. Galt, Cesar A. Santana & Raghuveer K. Halkar

  2. Mid America Heart Institute, Kansas City, Mo

    Timothy M. Bateman, S. James Cullom & James A. Case

  3. Hartford Hospital, Hartford, Conn

    Gary V. Heller

  4. Rhode Island Hospital, Providence, RI

    Lynne L. Johnson

Authors
  1. Gabriel B. Grossman
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  2. Ernest V. Garcia
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  3. Timothy M. Bateman
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  4. Gary V. Heller
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  5. Lynne L. Johnson
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  6. Russell D. Folks
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  7. S. James Cullom
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  8. James R. Galt
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  9. James A. Case
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  10. Cesar A. Santana
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  11. Raghuveer K. Halkar
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Additional information

Dr Grossman was funded in part by a grant from CAPES-Brazilian Research Agency through the Cardiovascular Science and Cardiology Graduate Program from the Federal University of Rio Grande do Sul, Brazil.

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Grossman, G.B., Garcia, E.V., Bateman, T.M. et al. Quantitative Tc-99m sestamibi attenuation-corrected SPECT: Development and multicenter trial validation of myocardial perfusion stress gender-independent normal database in an obese population. J Nucl Cardiol 11, 263–272 (2004). https://doi.org/10.1016/j.nuclcard.2004.02.007

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  • DOI: https://doi.org/10.1016/j.nuclcard.2004.02.007

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