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Istituto di fisiologia clinica

Torna all'elenco Contributi in rivista anno 2007

Contributo in rivista

Tipo: Articolo in rivista

Titolo: Feasibility and diagnostic accuracy of a Gated SPECT early-imaging protocol: a multicenter study of the Myoview Imaging Optimization Group

Anno di pubblicazione: 2007

Autori: Giorgetti A.; Rossi M.; Stanislao M.; Valle G.; Bertolaccini P.; Maneschi A.; Giubbini R.; De Rimini M. L.; Mazzanti M.; Cappagli M.; Milan E.; Volterrani D.; Marzullo P.

Affiliazioni autori: CNR Institute of Clinical Physiology, Pisa, Italy

Autori CNR:

  • PAOLO MARZULLO

Lingua: inglese

Abstract: The aim of this study was to investigate whether early (time 1, or T1) myocardial tetrofosmin imaging is feasible and as accurate in detecting coronary artery disease as is standard delayed (time 2, or T2) imaging. METHODS: One hundred twenty patients (100 men and 20 women; mean age +/- SD, 61 +/- 10 y) with anginal symptoms underwent tetrofosmin gated SPECT. Stress/rest T1 imaging was performed at 15 min and T2 at 45 min after injection. Image quality was visually evaluated using a 4-point scale (from 0 = poor to 3 = optimal). Myocardial perfusion analysis was performed on a 20-segment model using quantitative perfusion SPECT software, and reversible ischemia was scored as a summed difference score (SDS). Coronary angiography was performed within 1 mo on all patients, and stenosis of more than 50% of the diameter was considered significant. RESULTS: Overall, quality was scored as optimal or good for 94% of T1 images and 95% of T2 images (P = not statistically significant). Heart, lung, liver, and subdiaphragmatic counts did not differ for stress and rest T1 and T2 imaging. A good linear relationship was seen between T1 and T2 SDS (r = 0.69; P 0.0001), and Bland-Altman analysis showed good agreement between the 2 conditions. In terms of global diagnostic accuracy, areas under the receiver-operating-characteristic curve were comparable between T1 and T2 (0.80 vs. 0.81, P 2). Linear regression analysis showed a good correlation between T1 and T2 SDS (r = 0.67; P 0.0001), whereas the Bland-Altman method showed a shift in the mean value of the difference of +2.67 +/- 2.73. In patients with a T1 - T2 SDS of more than 2, areas under the receiver-operating-characteristic curves were significantly higher for T1 than for T2 images (0.79 vs. 0.70, P 0.001). CONCLUSION: T1 imaging is feasible and as accurate as T2 imaging in identifying coronary artery disease. However, in a discrete subset of patients, early acquisition strengthens the clinical message of defect reversibility by permitting earlier, more accurate identification of more severe myocardial ischemia.

Lingua abstract: inglese

Pagine da: 1670

Pagine a: 1675

Rivista:

The Journal of nuclear medicine Society of Nuclear Medicine.
Paese di pubblicazione: Stati Uniti d'America
Lingua: inglese
ISSN: 0161-5505

Numero volume: 48

DOI: 10.2967/jnumed.106.039107

Indicizzato da: ISI Web of Science (WOS) [000252894800037]

Parole chiave:

  • Tetrofosmin
  • Gated Spect
  • Myocardial imaaging

Strutture CNR:

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