Comparative Diagnostic Accuracy of Tl-201 and Tc-99m Sestamibi SPECT Imaging (Perfusion and ECG-Gated SPECT) in Detecting Coronary Artery Disease in Women

Taillefer, Raymond; DePuey, E. Gordon; Udelson, James E.; Beller, George A.; Latour, Y; Reeves, François

doi:10.1016/s0735-1097(96)00435-4

Cited by 364 publications

(124 citation statements)

References 25 publications

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“…In comparing the diagnostic accuracy of 201Tl with gated 99mTc-sestamibi SPECT in women, the sensitivity for detecting CAD was 80%, and test specificity improved dramatically from 67% for 201Tl to 92% for gated 99mTc-sestamibi SPECT [45].…”

Section: Myocardial Perfusionmentioning

confidence: 98%

Gender Differences in Coronary Artery Disease

Wake¹,

Yoshiyama²

2012

Coronary Artery Disease - Current Concepts in Epidemiology, Pathophysiology, Diagnostics and Treatment

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Section: Myocardial Perfusionmentioning

confidence: 98%

Gender Differences in Coronary Artery Disease

Wake¹,

Yoshiyama²

2012

Coronary Artery Disease - Current Concepts in Epidemiology, Pathophysiology, Diagnostics and Treatment

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“…Com isso, verificou-se uma diminuição dos estudos com resultados questionáveis tanto para a normalidade quanto para a anormalidade. Neste sentido, o principal benefício foi observado na população do sexo feminino, considerando-se a redução dos artefatos de atenuação na parede anterior do ventrículo esquerdo, ocasionados por tecido mamário (37).…”

Section: Doença Cardiovascular Nas Mulheres Diabéticasunclassified

“…Apesar das vantagens potenciais da metodologia nas mulheres, até o presente momento há um limitado número de estudos envolvendo a cintilografia do miocárdio no sexo feminino (19,37). O sexo não parece ser motivo de diferença estatística para os pacientes submetidos ao estudo de perfusão com finalidade de estratificação de risco pré-operatório.…”

Section: Doença Cardiovascular Nas Mulheres Diabéticasunclassified

“…O sexo não parece ser motivo de diferença estatística para os pacientes submetidos ao estudo de perfusão com finalidade de estratificação de risco pré-operatório. Na avaliação comparativa entre o esforço físico e o estresse farmacológico, a acurácia diagnóstica é semelhante em relação ao resultado das imagens, mas, em geral, com pequena inclusão de pacientes do sexo feminino nos estudos (37,38). Estudos que empregam a cintilografia na avaliação de isquemia em diabéticos mostram alta prevalência, incluindo as pacientes sem sintomas cardiovasculares (9,25).…”

Section: Doença Cardiovascular Nas Mulheres Diabéticasunclassified

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Doença cardiovascular em mulheres diabéticas assintomáticas

Smanio

2007

Arq Bras Endocrinol Metab

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RESUMOA doença cardiovascular é a principal causa de morbi-mortalidade em pacientes diabéticos. A isquemia do miocárdio é freqüentemente assintomática, levando a um diagnóstico tardio e prejudicando o prognóstico. Como o risco de eventos cardiovasculares pode ser modificado pela triagem apropriada, a identificação precoce da doença arterial coronária é de grande benefício, em particular no sexo feminino. Ainda não há consenso sobre que paciente deve ser investigada e quando deve ser iniciada a investigação diagnóstica. A decisão sobre qual método diagnóstico não-invasivo deva ser o empregado na triagem inicial é complexa, devendo conhecer-se a prevalência da doença para justificar a investigação de rotina. Cardiovascular disease is the main cause of cardiac death among diabetic patients. The myocardial ischemia is frequently asymptomatic, leading to late diagnosis and making prognosis worse. This is particularly true for women, for whom this diagnostic is possibility often disregarded. Appropriate screening can modify the coronary artery disease risk. The early diagnosis is highly beneficial, particularly regarding females. The decision of which non-invasive diagnostic method should be used in the initial evaluation is difficult. There are several diagnostic methods to make the preliminary investigation of coronary artery disease in diabetic women even without cardiac symptoms, but there is still no consensus about who should be investigated and when should the first cardiac evaluation start. The prevalence of the disease, as well as the cardiac risk, must be known in order to justify a broad survey, mainly in the female population. DIABETES E DOENÇA CARDIOVASCULARA PREVALÊNCIA DE DIABETES vem aumentando rápida e continuamente nas últimas décadas, e toma proporções epidêmicas. Atualmente, estima-se que 150 milhões de indivíduos no mundo sejam portadores de diabetes, e que até o ano 2025 esse número esteja duplicado. Esses indivíduos são considerados de alto risco para desordens vasculares que afetam coração, cére-bro, rins e vasos periféricos (1,2). A prevalência crescente de obesidade e de sedentarismo nos países desenvolvidos e em desenvolvimento, considerada

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“…SPECT findings such as the extent, severity and reversibility of perfusion defects have shown to be valuable for the prediction of future cardiovascular events [3]. In the absence of morphological correlation, however, SPECT is limited in allocating perfusion defects to their determining coronary lesion, which is a major precondition for accurate therapy planning [4]. As a consequence, invasive conventional coronary angiography (CCA) is often performed in cases of abnormal or equivocal SPECT findings [5].…”

mentioning

confidence: 99%

Detection of myocardial perfusion abnormalities: standard dual-source coronary computed tomography angiography versus rest/stress technetium-99m single-photo emission CT

Cheng

Zeng²,

Arellano³

et al. 2010

BJR

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ABSTRACT. We compared coronary dual-source computed tomography angiography (corDSCTA) with technetium-99m single-photon emission computed tomography (SPECT) for the detection of myocardial perfusion abnormalities. Fifty-five consecutive patients underwent both gated myocardial perfusion SPECT and corDSCTA, the latter during a single arterial-phase injection of contrast agent. The perfusion defects visualised by corDSCTA correlated with the findings of rest/stress SPECT. Abnormal findings on stress SPECT, which were due to either ischaemia or infarct, were found in 24 patients. In comparison to SPECT at rest, corDSCTA detected perfusion defects with a sensitivity and specificity of 100% and 78%, respectively. Compared to SPECT at stress, the sensitivity and specificity values of corDSCTA were 83.3% and 90.3%, respectively. On corDSCTA , the average attenuation values of perfusion defects that corresponded to chronic infarcts (28.5¡22.2 HU) were significantly lower (p50.002) than those of non-infarct-related perfusion defects (43.1¡17.5 HU). Using rest/stress SPECT is the gold standard for the diagnosis of myocardial ischaemia, corDSCTA was able to diagnose ischaemic disease (defined as the presence of high-grade stenotic CAD (>50% luminal narrowing)) with a sensitivity and specificity of 59% and 89%, respectively, in patients with no known history of myocardial infarction (n54). Thus, corDSCTA may serve as a diagnostic tool for the detection of perfusion abnormalities (first) visualised by SPECT. There appears to be a limited correlation between coronary stenotic disease and SPECT findings. Coronary artery disease (CAD) is one of the leading causes of morbidity and mortality in developed countries. During the progression of atherosclerosis, the coronary artery wall undergoes pathological changes with build-up of plaque and subsequent luminal narrowing resulting in impaired blood supply to the myocardium. The focus of perfusion imaging is the detection of pathological changes in myocardial perfusion. At present, various perfusion imaging techniques are in clinical use, including nuclear medicine modalities such as single-photon emission computed tomography (SPECT), positron emission tomography (PET) and cardiac perfusion MRI.Rest/stress myocardial perfusion SPECT imaging is a non-invasive modality that is widely used to evaluate patients with suspected CAD. Compared with conventional coronary angiography, myocardial perfusion SPECT has demonstrated sensitivities and specificities of 82-98% and 44-91%, respectively, for the detection of CAD [1,2]. SPECT findings such as the extent, severity and reversibility of perfusion defects have shown to be valuable for the prediction of future cardiovascular events [3]. In the absence of morphological correlation, however, SPECT is limited in allocating perfusion defects to their determining coronary lesion, which is a major precondition for accurate therapy planning [4]. As a consequence, invasive conventional coronary angiography (CCA) is often performed in cases of abnorma...

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Comparative Diagnostic Accuracy of Tl-201 and Tc-99m Sestamibi SPECT Imaging (Perfusion and ECG-Gated SPECT) in Detecting Coronary Artery Disease in Women

Abstract: Both Tl-201 SPECT and Tc-99m sestamibi SPECT perfusion studies had a similar sensitivity for the detection of CAD in women. However, Tc-99m sestamibi SPECT perfusion imaging shows a significantly better specificity, which is further enhanced by the use of ECG gating.

Cited by 364 publications

References 25 publications

Gender Differences in Coronary Artery Disease

Gender Differences in Coronary Artery Disease

Doença cardiovascular em mulheres diabéticas assintomáticas

Detection of myocardial perfusion abnormalities: standard dual-source coronary computed tomography angiography versus rest/stress technetium-99m single-photo emission CT

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