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Diagnostic performance of low-dose rest/stress Tc-99m tetrofosmin myocardial perfusion SPECT using the 530c CZT camera: Quantitative vs visual analysis

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

We set out to develop normal databases and prospectively validate abnormality criteria for a low-dose Tc-99m tetrofosmin myocardial perfusion SPECT protocol using the 530c CZT camera.

Methods

All patients received 6 mCi rest/20 mCi stress doses of Tc-99m tetrofosmin. Rest and stress images were obtained over 7-9 and 5-7 minutes according to the chest size. Low-dose CT of the chest was obtained on a standalone CT scanner. Forty patients with very low likelihood (LLK) of coronary artery disease (CAD) were used to define the normal count distributions. The abnormality criteria were prospectively validated in 55 patients who had coronary angiography and in 40 patients with LLK of CAD.

Results

The results for quantitative non-attenuation-corrected (AC) and AC analysis and visual analysis were as follows: sensitivity of 79%, 85%, and 92% (P = NS) and specificity of 44%, 75%, and 56% (P = NS), respectively. The normalcy rates for quantitative non-AC and AC analyses and visual analysis were 95%, 98%, and 98% (P = NS).

Conclusions

We have developed non-AC and AC normal databases for low-dose rest/stress Tc-99m tetrofosmin myocardial perfusion SPECT protocol using the 530c CZT camera. The per-patient diagnostic performance of quantitative analyses is not significantly different from visual analysis by an experienced reader.

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Acknowledgments

This work was funded in part by GE Healthcare. Two of the authors (RF, EVG) and Emory University receive royalties from the sale of the Emory Cardiac Toolbox™ utilized to interpret images in the research described in this article. The terms of this arrangement have been reviewed and approved by Emory University in accordance with its conflict-of-interest practice.

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Authors and Affiliations

  1. Department of Radiology, Emory University School of Medicine, 1364 Clifton Road, NE, Atlanta, GA, 30322, USA

    Fabio P. Esteves MD, James R. Galt (PhD), Russell D. Folks (CNMT), Liudmila Verdes (MD) & Ernest V. Garcia (PhD)

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  1. Fabio P. Esteves MD
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  2. James R. Galt
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  3. Russell D. Folks
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  4. Liudmila Verdes
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  5. Ernest V. Garcia
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Correspondence to Fabio P. Esteves MD.

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Esteves, F.P., Galt, J.R., Folks, R.D. et al. Diagnostic performance of low-dose rest/stress Tc-99m tetrofosmin myocardial perfusion SPECT using the 530c CZT camera: Quantitative vs visual analysis. J. Nucl. Cardiol. 21, 158–165 (2014). https://doi.org/10.1007/s12350-013-9827-7

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  • DOI: https://doi.org/10.1007/s12350-013-9827-7

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