Published in:
01-02-2014 | Original Article
Diagnostic accuracy of high-resolution attenuation-corrected Anger-camera SPECT in the detection of coronary artery disease
Authors:
Harshal R. Patil, MD, Timothy M. Bateman, MD, A. Iain McGhie, MD, Eric V. Burgett, MS, CNMT, Staci A. Courter, MA, James A. Case, PhD, Gary V. Heller, MD, PhD
Published in:
Journal of Nuclear Cardiology
|
Issue 1/2014
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Abstract
Background
There is limited data on diagnostic accuracy of recently introduced high-resolution Anger (HRA) SPECT incorporating attenuation correction (AC), noise reduction, and resolution recovery algorithms. We therefore studied 54 consecutive patients (excluding those with prior MI or cardiomyopathy) who had HRA-AC SPECT and coronary angiography (CA) ≤ 30 days and no change in symptoms.
Methods
The HRA-AC studies were acquired in 128 × 128 matrix (3.2 mm pixel) format with simultaneous Gd-153 line-source AC. Measured variables were image quality, interpretive certainty, sensitivity and specificity for any CAD, sensitivity for single- and multivessel CAD, and the influence of gender, body mass index (BMI), and stress modality.
Results
The mean age of the patients was 66 ± 11 years with a BMI of 32 ± 7 kg·m−2. Mean interpretive certainty score was 2.7 on a 3-point scale and mean image quality score was 3.3 on a 4-point scale. Stress perfusion defects were detected in 34 of 38 patients with obstructive CAD [sensitivity 89%, 95% confidence interval (CI) 76%-95%]. The specificity was 75% (CI 51%-90%) and overall diagnostic accuracy was 85% (CI 73%-92%). Accuracy did not differ for females vs males, for BMI ≤30 vs >30, or for pharmacologic vs exercise SPECT. Sensitivity for single-vessel disease was 88% (CI 69%-96%) and for multivessel disease was 93% (CI 69%-99%).
Conclusion
New Anger technology incorporating innovative improvements results in high image quality with excellent interpretive certainty and high diagnostic accuracy.