Diagnostic accuracy of gated Tc-99m sestamibi stress myocardial perfusion SPECT with combined supine and prone acquisitions to detect coronary artery disease in obese and nonobese patients
| Autor: | Hidetaka Nishina, Daniel S. Berman, Guido Germano, Xingping Kang, Piotr J. Slomka, John D. Friedman, Ishac Cohen, Leslee J. Shaw, James Gerlach, Sean W. Hayes |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Technetium Tc 99m Sestamibi
medicine.medical_specialty Supine position Posture Coronary Artery Disease Overweight Risk Assessment Sensitivity and Specificity California Coronary artery disease Risk Factors Internal medicine Image Interpretation Computer-Assisted medicine Body Size Humans Radiology Nuclear Medicine and imaging Obesity Myocardial infarction Aged Retrospective Studies Tomography Emission-Computed Single-Photon business.industry Reproducibility of Results nutritional and metabolic diseases Gated Blood-Pool Imaging Image Enhancement Prognosis medicine.disease Stenosis Exercise Test Cardiology Radiopharmaceuticals medicine.symptom Artifacts Cardiology and Cardiovascular Medicine business Perfusion Body mass index |
| Zdroj: | Journal of Nuclear Cardiology. 13:191-201 |
| ISSN: | 1532-6551 1071-3581 |
| DOI: | 10.1007/bf02971243 |
| Popis: | The diagnostic value of gated myocardial perfusion single-photon emission computed tomography (MPS) with combined supine and prone acquisitions to detect coronary artery disease (CAD) in obese and nonobese patients has not been defined.We studied 1511 patients without prior myocardial infarction or coronary revascularization who either had coronary angiography within 3 months of MPS (n = 785) or had a low pretest likelihood of CAD (n = 726). All patients underwent rest thallium 201/gated exercise or adenosine stress technetium 99m sestamibi MPS in both the supine and prone positions. According to body mass index (BMI), patients were categorized as normal weight (BMI of 18.5-24.9 kg/m2), overweight (BMI of 25.0-29.9 kg/m2), or obese (BMIor = 30.0 kg/m2). There were no significant differences in stress, fixed, or ischemic defects among patients in different weight categories. The sensitivity of MPS was 85%, 86%, and 89% for detecting patients with 50% or greater coronary stenosis and 89%, 91%, and 92% for detecting those with 70% or greater coronary stenosis in the normal-weight, overweight, and obese groups, respectively. Normalcy rates were nearly identical among the 3 weight groups (99%, 98%, and 99%, respectively). Multivariate logistic regression analysis further confirmed that BMI was a nonsignificant predictor for the detection of CAD. In a subset of 290 patients, automated quantitative MPS analysis confirmed that combined supine and prone MPS increased specificity (86%) in identifying CAD, without a significant reduction in sensitivity (83% foror = 50% stenosis and 88% foror = 70% stenosis).The findings of this study suggest that MPS performed with gating and combined supine and prone acquisitions without attenuation correction had a similar diagnostic accuracy for the detection of CAD in normal-weight, overweight, and obese patients. |
| Databáze: | OpenAIRE |
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