Abstract
Experimental studies have been made of lesion detectability in myocardial perfusion studies using thallium-201. A series of images (AP view) was generated mathematically. Images were simulated with 100k, 200k, and 300k counts for the complete image and either non- or half-perfused lesions (lesion volume 1–61/2% of total myocardial volume). In addition thallium images were generated excluding scatter; images were also generated with a radiopharmaceutical using 140, 184 and 296 keV, assuming the biological distribution of thallium. All images were interpreted by seven observers. Count density did not affect the true-positive fraction of the interpretations. However, the false-positive fraction decreased significantly when count density increased. Lesions located far from the camera were detected worst. The intraobserved variability was largest for interpretation of these regions. Small lesions were poorly detected. Perfusion of lesions significantly affected their detection, independent of the count density, lesion volume, and lesion location. Scatter did not affect the detection of lesions. No significant difference was found when the performance of the observers was compared for 80 keV and 140 keV. The use of 184-keV and 296-keV photons resulted in a lower detection rate probably because of the use of a high energy collimator.
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Vos PH, Vossepoel AM, Hermans J, Pauwels EKJ (1982) Detection of lesions in thallium-201 myocardial scintigraphy Eur J Nucl Med 7:174–180
Vos PH (1982) Nuclear cardiology. Thesis, University of Leiden
Lenaers A, Block P, Van Thiel E, Lebedelle M, Becquevort P, Erbsmann F, Ermans AM (1977) Segmental analysis of Tl-201 stress myocardial scintigraphy. J Nucl Med 18:509–516
Mueller TM, Marcus ML, Ehrhardt JC, Chaudhuri T, Abboud FM (1976) Limitations of thallium-201 myocardial perfusion scintigram. Circulation 54:640–646
Vos PH, Vossepoel AM, Hermans J, Pauwels EKJ (1981) Evaluation of lesion detectability in thallium-201 scintigraphy using a mathematical model for the heart, Proc 2nd IEEE Conf Med Imaging and Psychophysics, Brussels, pp 87–93
Vos PH, Vossepoel AM, Pauwels EKJ (1982) Detection of lesions in thallium-201 myocardial perfusion scintigraphy. Proc 3rd World Congress Fed Nucl Med Biol, Paris, pp 761–764
Okada RD, Boucher CA, Kirshenbaum HK, Kushner FG, Strauss HW, Block PC, McKusick KA, Pohost GM (1980) Improved diagnostic accuracy of thallium-201 stress test using multiple observers and criteria derived from interobserver analysis of variance. Am J Cardiol 46:619–624
Atwood JE, Jensen D, Froelicher V, Witztum K, Gerber K, Gilpin E, Ashburn W (1981) Agreement in human interpretation of analog thallium myocardial perfusion images. Circulation 64:601–609
Cook DJ, Bailey I, Strauss HW, Rouleau J, Wagner HN Jr, Pitt B (1976) Thallium-201 for myocardial imaging: Appearance of the normal heart. J Nucl Med 17:583–589
Massie BM, Botvinnick E, Brundage BH (1979) Correlation of thallium-201 scintigrams with coronary anatomy: Factors affecting region by region sensitivity. Am J Cardiol 44:616–622
Hamilton GW, Trobaugh GH, Ritchie JL, Williams DL, Weaver WD, Gould KL (1977) Myocardial imaging with intravenously injected thallium-201 in patient with suspected coronary artery disease. Am J Cardiol 39:347–354
Turner DA, Fordham EW, Pagano JV, Ali AA, Ramos MV, Ramachamdran PC (1976) Brain scanning with the Anger multiplane scanner as a second examination. Evaluation by the ROC method. Radiology 121:115–124
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Vos, P.H., Pauwels, E.K.J. & Vossepoel, A.M. Thallium myocardial perfusion scintigraphy: Influence of Perfusion, Scatter, and photon energy on the detection of lesions. Cardiovasc Intervent Radiol 9, 7–12 (1986). https://doi.org/10.1007/BF02576974
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DOI: https://doi.org/10.1007/BF02576974