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Head-to-head comparison of diagnostic accuracy of stress-only myocardial perfusion imaging with conventional and cadmium-zinc telluride single-photon emission computed tomography in women with suspected coronary artery disease

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Breast attenuation may impact the diagnostic accuracy of stress myocardial perfusion imaging (MPI) with single-photon emission computed tomography (SPECT). We compared the performance of conventional (C)-SPECT and cadmium-zinc-telluride (CZT)-SPECT systems in women with low-intermediate likelihood of coronary artery disease (CAD).

Methods and Results

A total of 109 consecutive women underwent stress-optional rest MPI by both C-SPECT and CZT-SPECT. In the overall study population, a weak albeit significant correlation between total perfusion defect (TPD) measured by C-SPECT and CZT-SPECT was observed (r = 0.38, P < .001) and at Bland-Altman analysis the mean difference in TPD (C-SPECT minus CZT-SPECT) was 2.40% (P < .001). Overall concordance of semi-quantitative diagnostic performance between C-SPECT and CZT-SPECT was observed in 52 (48%) women with a κ value of 0.09. Normalcy rate was significantly higher using CZT-SPECT compared to C-SPECT (P < .001). Machine learning analysis performed through the implementation of J48 algorithm proved that CZT-SPECT has higher sensitivity, specificity, and accuracy than C-SPECT.

Conclusions

In women with low-intermediate likelihood of CAD, there is a poor concordance of diagnostic performance between C-SPECT and CZT-SPECT, and CZT-SPECT allows better normalcy rate detection compared to C-SPECT.

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Abbreviations

SPECT:

Single-photon emission computed tomography

MPI:

Myocardial perfusion imaging

CAD:

Coronary artery disease

C:

Conventional

CZT:

Cadmium-zinc-telluride

ECG:

Electrocardiography

SSS:

Summed stress score

TPD:

Total perfusion defect

LV:

Left ventricular

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Disclosure

T. Mannarino, R. Assante, C. Ricciardi, E. Zampella, C. Nappi, V. Gaudieri, C.G. Mainolfi, E. Di Vaia, M. Petretta, M. Cesarelli, A. Cuocolo and W. Acampa declare that they have no conflict of interest.

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Author notes

  1. Teresa Mannarino and Roberta Assante are the first two authors shared first co-authorship.

Authors and Affiliations

  1. Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy

    Teresa Mannarino MD, Roberta Assante MD, PhD, Carlo Ricciardi MSc, Emilia Zampella MD, PhD, Carmela Nappi MD, PhD, Valeria Gaudieri MD, PhD, Ciro Gabriele Mainolfi MD, Eugenio Di Vaia MD, Alberto Cuocolo MD & Wanda Acampa MD, PhD

  2. Department of Translational Medical Sciences, University Federico II, Naples, Italy

    Mario Petretta MD

  3. Department of Electrical Engineering and Information Technology, University Federico II, Naples, Italy

    Mario Cesarelli MSc

  4. Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy

    Wanda Acampa MD, PhD

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  1. Teresa Mannarino MD
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Correspondence to Wanda Acampa MD, PhD.

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Mannarino, T., Assante, R., Ricciardi, C. et al. Head-to-head comparison of diagnostic accuracy of stress-only myocardial perfusion imaging with conventional and cadmium-zinc telluride single-photon emission computed tomography in women with suspected coronary artery disease. J. Nucl. Cardiol. 28, 888–897 (2021). https://doi.org/10.1007/s12350-019-01789-7

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