Interpretation and Reporting of Gated Myocardial Perfusion SPECT

Are Shades of Gray Prognostically Useful in Reporting Myocardial Perfusion Single-Photon Emission Computed Tomography?

“…However, considering the complexity of the findings on MPS, we have advocated the use of a 5-category approach ("normal," "probably normal," "equivocal," "probably abnormal," and "definitely abnormal") to final interpretation of myocardial perfusion SPECT, 2 and this approach has been used by others. 3,4 Furthermore, we have suggested that due to the subjectivity of semiquantitative visual interpretation, allowing flexibility of shifting by 1 category of clinical certainty in the final interpretation based on nonperfusion MPS findings and the available clinical information would enhance the clinical relationship between scan findings and patient outcomes.…”

“…3,4 Furthermore, we have suggested that due to the subjectivity of semiquantitative visual interpretation, allowing flexibility of shifting by 1 category of clinical certainty in the final interpretation based on nonperfusion MPS findings and the available clinical information would enhance the clinical relationship between scan findings and patient outcomes. 2 Nonetheless, the added value of expressing levels of certainty compared with a dichotomous normal/abnormal categorization or an approach based solely on summed perfusion scores is unclear.…”

“…For the final clinical interpretation, the interpreter was permitted to shift the level of certainty in the final interpretation by 1°, based on non-MPS clinical information 2 ; for example, a study considered equivocal by segmental scoring could be considered probably abnormal or probably normal, based on consideration of the nonperfusion findings and the available clinical information. The level of certainty of the final clinical interpretation was reported in all patients to the referring physician as a part of the clinical MPS report.…”

ASNC imaging guidelines for nuclear cardiology procedures

“…A number of the data elements contained in the tables have been derived from, and harmonized with, other guideline documents, some multisocietal and others ASNC-specific. 3,4,[17][18][19][20][21] This update also addresses additional modalities that were not included in the prior versions of the document, such as: broader treatment of PET and viability, and non-perfusion imaging including amyloid detection, inflammation/infection, MIBG in heart failure and coronary calcium scoring, and its incorporation into the nuclear cardiology report. The data elements required for reporting the additional modalities have been added to specific tables where appropriate or additional tables have been added to the document to cover those items that were specific to the modality and could not be generalized to one of the existing table headings.…”

Evaluation of myocardial perfusion and viability in coronary artery disease in view of the new revascularization guidelines

“…PET is considered a "gold standard" in myocardial perfusion assessment -the sensitivity and specificity of this method in the assessment of perfusion disorders in patients with coronary artery disease have been determined in 8 independent studies at 93-97% respectively -on average 93% and 88-100% -on average 92% [19], and furthermore it enables quantitative assessment of perfu sion in mL/g of myocardial tissue/min using N13NH 3 …”