Improved diagnostic accuracy of thallium-201 myocardial perfusion single-photon emission computed tomography with CT attenuation correction

Huang, Jian-Jia; Yen, Ruoh‐Fang; Lee, Wen‐Chung; Huang, Chun‐Kai; Hsu, Powen; Cheng, Mei‐Fang; Lu, Ching-Chu; Lin, Yen-Hung; Chien, Kuo‐Liong; Wu, Yen‐Wen

doi:10.1007/s12350-018-1230-y

Cited by 15 publications

(18 citation statements)

References 46 publications

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“…In this issue of the journal, Huang et al, have contributed to this trend by showing the value of CT attenuation for thallium SPECT MPI imaging. 1 Although attenuation correction has been in clinical use since the early 1990s and attenuation correction with CT has been available since at least 2005, their publication contributes to the body of knowledge in several important ways. 2 Very few previous studies have evaluated attenuation correction for thallium imaging.…”

Section: See Related Article Pp Pp 1584-1595mentioning

confidence: 99%

CT attenuation correction for thallium SPECT MPI and other benefits of multimodality imaging

Thompson

2019

Journal of Nuclear Cardiology

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Section: See Related Article Pp Pp 1584-1595mentioning

confidence: 99%

CT attenuation correction for thallium SPECT MPI and other benefits of multimodality imaging

Thompson

2019

Journal of Nuclear Cardiology

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“…Coronary artery diseases cause one third of all mortality per year worldwide; though, in the developing countries, proportion of referrals for myocardial perfusion imaging (MPI) have not been studied [1]. Therefore, single-photon emission computed tomography (SPECT) as a technique for myocardial perfusion imaging has been performed in many countries [2,3]. Moreover, myocardial perfusion scintigraphy (MPS) investigates patients with probable coronary artery disease.…”

Section: Introductionmentioning

confidence: 99%

Untitled

2022

IJNMRS

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Introduction: Coronary artery disease causes one third of all mortality per year throughout the world. In patient with suspicions coronary artery disease many diagnostic imaging procedure obtained. ACCF/ASNC AUC2009 was developed as a guide in cardiology for evaluation of patient with cardiovascular disease. The aim of this study is the evaluation of appropriateness of patient referring to our nuclear medicine center according to the AUC-2009 lastly published by ACCF/ASNC. Methods: All patients that referred to our center from 2017/02/03 to 2017/06/15 enrolled in this study. Based on the AUC-2009 criteria, patients were classified as appropriate, inappropriate, uncertain and unclassified. Then the prevalence of each groups determined and the correlation with sex, age and myocardial perfusion scintigraphy results were evaluated.Results: 875 patients were enrolled in this study. The mean age was 58.6±12 years and 58.9% of all patients were female. Stress phase of MPI was performed with exercise test in 132 (15.3%), dipyridamole stress test in 716 (83.1%) and dobutamine stress test in 13 (1.4%) of the patients. In 500 (57.1%) of patients the results of MPI was abnormal. From all patients 72 individuals (8.2%) referred for myocardial viability evaluation, 76(8.6%) had history of previous CABG, 77(8.8%) had previous history of PTCA and 36(4.1%) referred for preoperative evaluation of non-cardiac surgery. From all patients, 696(79.5%) patients were found as "appropriate", 165 (18.9%) as "inappropriate", 8 (0.9%) as "uncertain" and 6(0.7%) patients as unclassified based on ACCF/ASNM AUC 2009 criteria. Conclusion:This study revealed the referring patients for MPI in our academic center are closely correlated to the ACCF/ ASNM AUC 2009 criteria. The probability of abnormal MPI result was significantly greater in appropriate group than other groups. No statistically significant difference was observed in age and gender among the groups. The most probable cause of referring for MPI in appropriate group was inability to perform exercise test (61%) and the most probable cause of patient classified as inappropriate was ability to performing exercise test (45.5%).

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“…Previous studies have evaluated the effect of AC in the patient-based diagnostic performance for CAD and assessed its effect in individual coronary arteries with stenosis. For example, some studies have reported that AC can increase the specificity of detecting RCA stenosis (13)(14)(15), however the results have been inconsistent with regards to LAD and LCX disease. One study reported no difference in specificity (13), another showed decreased specificity (15), and another showed increased specificity (14).…”

Section: Introductionmentioning

confidence: 99%

“…For example, some studies have reported that AC can increase the specificity of detecting RCA stenosis (13)(14)(15), however the results have been inconsistent with regards to LAD and LCX disease. One study reported no difference in specificity (13), another showed decreased specificity (15), and another showed increased specificity (14). Furthermore, another study showed increased diagnostic sensitivity in three vessel territories, increased specificity in the LAD and LCX, but no change in the RCA (16).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Effect of Attenuation Correction in Myocardial Perfusion Imaging in Different Coronary Arteries: A Systematic Review and Meta-Analysis

Huang

Yen

et al. 2021

Front. Cardiovasc. Med.

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Background: The aim of this study was to determine whether, and if so how, attenuation correction (AC) improves the diagnostic performance of myocardial perfusion imaging (MPI) in different coronary artery-supplied territories, using coronary angiography as the reference standard.Methods: PubMed and EMBASE were searched until December 2020 for studies evaluating AC MPI for the diagnosis of coronary artery disease (CAD) with vessel-based data. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. For each study, the sensitivity, specificity, diagnostic odds ratios and areas under summary receiver operating characteristic curves (AUC) with 95% confidence intervals were calculated to determine the diagnostic accuracy of AC compared to non-AC MPI. A bivariate mixed-effects model was used to pool the data. Subgroup analyses considering the type of radiotracer and type of AC were performed.Results: A total of 264 articles were screened, of which 22 studies (2,608 patients) were enrolled. Significant improvements in specificity [0.78 vs. 0.58 in overall CAD, 0.87 vs. 0.61 in right coronary artery (RCA)] and diagnostic odds ratios (16 vs. 8 in overall CAD, 18 vs. 7 in RCA) after AC were shown in overall CAD at a patient level and RCA stenosis. Improvements in AUC were also noted. MPI had a similar diagnostic performance for detecting left anterior descending and left circumflex coronary artery stenosis with or without AC. There were trends of decreased sensitivity after AC, but none were significant. Diagnostic odds ratio showed significant improvement after AC only in the technetium-99m subgroup.Conclusion: The results of this study suggest that AC should be applied to MPI to improve the diagnosis of CAD regardless of which type of radiotracer, and that AC MPI can improve the specificity of detecting RCA stenosis.

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Improved diagnostic accuracy of thallium-201 myocardial perfusion single-photon emission computed tomography with CT attenuation correction

Abstract: CTAC significantly improved diagnostic performance primarily by increasing the specificity, and the improvements were significantly greater in obese patients and male patients. These findings suggest that CTAC should be applied to Tl-201 MPI as routine clinical practice.

Cited by 15 publications

References 46 publications

CT attenuation correction for thallium SPECT MPI and other benefits of multimodality imaging

CT attenuation correction for thallium SPECT MPI and other benefits of multimodality imaging

Untitled

Diagnostic Effect of Attenuation Correction in Myocardial Perfusion Imaging in Different Coronary Arteries: A Systematic Review and Meta-Analysis

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