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Journal of Nuclear Cardiology
Published in: Journal of Nuclear Cardiology 6/2011

01-12-2011 | Original Article

Prognostic value of automated vs visual analysis for adenosine stress myocardial perfusion SPECT in patients without prior coronary artery disease: A case-control study

Authors: Yuan Xu, PhD, Ryo Nakazato, MD, Sean Hayes, MD, Rory Hachamovitch, MD, Victor Y. Cheng, MD, Heidi Gransar, MS, Romalisa Miranda-Peats, MPH, Mark Hyun, CNMT, Leslee J. Shaw, PhD, John Friedman, MD, Guido Germano, PhD, Daniel S. Berman, MD, Piotr J. Slomka, PhD

Published in: Journal of Nuclear Cardiology | Issue 6/2011

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Abstract

Purpose

We aimed to evaluate the prognostic value of automated quantitative hypoperfusion parameters derived from adenosine stress myocardial perfusion SPECT (MPS) for predicting sudden or cardiac death (CD) in case-controlled patients with suspected coronary artery disease (CAD).

Methods

We considered patients with available adenosine stress Tc-99m sestamibi MPS scans and follow-up information. 81 CD patients from a registry of 428 patients documented by the National Death Index were directly matched in a retrospective case-control design to patients without CD by key clinical parameters (age by deciles, gender, no early revascularization, pre-test likelihood categories, diabetes, and chest pain symptoms). Multivariable analysis of stress MPS total perfusion deficit (STPD) and major clinical confounders were used as predictors of CD. Visual 17-segment summed stress segmental scores (VSSS) obtained by an expert reader, were compared to STPD.

Results

CD patients had higher stress hypoperfusion measures compared to controls [STPD: 7.0% vs 3.6% (P < .05), VSSS: 5.3 vs 2.1 (P < .05)]. By univariate analysis, STPD and VSSS have similar predictive power (the areas under receiver operator characteristics curves: STPD = 0.64, VSSS = 0.63; Kaplan-Meier models: χ2 = 7.59, P = .0059 for STPD and χ2 = 11.10, P = .0009 for VSSS). The multiple Cox proportional hazards regression models with continuous perfusion measures showed that STPD had similar power to normalized VSSS as a predictor for CD (χ2 = 4.92; P = .027) vs (χ2 = 8.90; P = .003).

Conclusions

Quantitative analysis is comparable to expert visual scoring in predicting CD in a case-controlled study.
Literature
1.
Hachamovitch R, Hayes SW, Friedman JD, Cohen I, Berman DS. A prognostic score for prediction of cardiac mortality risk after adenosine stress myocardial perfusion scintigraphy. J Am Coll Cardiol 2005;45:722-9.PubMedCrossRef
2.
Shaw LJ, Berman DS, Hendel RC, Borges-Neto S, Min JK, Callister TQ. Prognosis by coronary computed tomographic angiography: Matched comparison with myocardial perfusion single-photon emission computed tomography. J Cardiovasc CT 2008;2:93-101.
3.
Hachamovitch R, Kang X, Amanullah AM, Abidov A, Hayes SW, Friedman JD, et al. Prognostic implications of myocardial perfusion single-photon emission computed tomography in the elderly. Circulation 2009;120:2197-206.PubMedCrossRef
4.
Hachamovitch R, Berman DS, Shaw LJ, Kiat H, Cohen I, Cabico JA, et al. Incremental prognostic value of myocardial perfusion single photon emission computed tomography for the prediction of cardiac death: Differential stratification for risk of cardiac death and myocardial infarction. Circulation 1998;97:535-43.PubMed
5.
Hachamovitch R, Berman DS, Kiat H, Cohen I, Lewin H, Amanullah A, et al. Incremental prognostic value of adenosine stress myocardial perfusion single-photon emission computed tomography and impact on subsequent management in patients with or suspected of having myocardial ischemia. Am J Cardiol 1997;80:426-33.PubMedCrossRef
6.
Pazhenkottil AP, Ghadri JR, Nkoulou RN, Wolfrum M, Buechel RR, Kuest SM, et al. Improved outcome prediction by SPECT myocardial perfusion imaging after CT attenuation correction. J Nucl Med 2011;52:196-200.PubMedCrossRef
7.
Xu Y, Hayes S, Ali I, Ruddy TD, Wells RG, Berman DS, et al. Automatic and visual reproducibility of perfusion and function measures for myocardial perfusion SPECT. J Nucl Cardiol 2010;17:1050-7.PubMedCrossRef
8.
Berman DS, Kang X, Gransar H, Gerlach J, Friedman JD, Hayes SW, et al. Quantitative assessment of myocardial perfusion abnormality on SPECT myocardial perfusion imaging is more reproducible than expert visual analysis. J Nucl Cardiol 2009;16:45-53.PubMedCrossRef
9.
Min JK, Berman D. Anatomic and functional assessment of coronary artery disease: Convergence of 2 aims in a single setting. Circ Cardiovasc Imaging 2009;2:163-5.PubMedCrossRef
10.
Berman DS, Kiat H, Friedman JD, Wang FP, van Train K, Matzer L, et al. Separate acquisition rest thallium-201/stress technetium-99m sestamibi dual-isotope myocardial perfusion single-photon emission computed tomography: A clinical validation study. J Am Coll Cardiol 1993;22:1455-64.PubMedCrossRef
11.
Berman DS, Kiat H, Friedman JD, Diamond G. Clinical applications of exercise nuclear cardiology studies in the era of healthcare reform. Am J Cardiol 1995;75:3D-13D.PubMedCrossRef
12.
Germano G, Kiat H, Kavanagh PB, Moriel M, Mazzanti M, Su HT, et al. Automatic quantification of ejection fraction from gated myocardial perfusion SPECT. J Nucl Med 1995;36:2138-47.PubMed
13.
Van Train KF, Garcia EV, Maddahi J, Areeda J, Cooke CD, Kiat H, et al. Multicenter trial validation for quantitative analysis of same-day rest-stress technetium-99m-sestamibi myocardial tomograms. J Nucl Med 1994;35:609-18.PubMed
14.
Hachamovitch R, Hayes SW, Friedman JD, Cohen I, Berman DS. Comparison of the short-term survival benefit associated with revascularization compared with medical therapy in patients with no prior coronary artery disease undergoing stress myocardial perfusion single photon emission computed tomography. Circulation 2003;107:2900-7.PubMedCrossRef
15.
Xu Y, Kavanagh P, Fish M, Gerlach J, Ramesh A, Lemley M, et al. Automated quality control for segmentation of myocardial perfusion SPECT. J Nucl Med 2009;50:1418-26.PubMedCrossRef
16.
Nishina H, Slomka PJ, Abidov A, Yoda S, Akincioglu C, Kang X, et al. Combined supine and prone quantitative myocardial perfusion SPECT: Method development and clinical validation in patients with no known coronary artery disease. J Nucl Med 2006;47:51-8.PubMed
17.
Slomka PJ, Nishina H, Berman DS, Akincioglu C, Abidov A, Friedman JD, et al. Automated quantification of myocardial perfusion SPECT using simplified normal limits. J Nucl Cardiol 2005;12:66-77.PubMedCrossRef
18.
Cox D. Regression models and life tables (with discussion). J R Stat Soc Series B Methodol 1972;34:187-220.
19.
Hachamovitch R, Beller GA. Critical review of imaging approaches for the diagnosis and prognosis of CAD. In: Di Carli MF, Kwong RY, editors. Novel techniques for imaging the heart: Cardiac MR and CT. Oxford: Wiley-Blackwell; 2008. p. 148-68.
20.
Weiss AT, Berman DS, Lew AS, Nielsen J, Potkin B, Swan HJ, et al. Transient ischemic dilation of the left ventricle on stress thallium-201 scintigraphy: A marker of severe and extensive coronary artery disease. J Am Coll Cardiol 1987;9:752-9.PubMedCrossRef
21.
Akaike H. A new look at the statistical model identification. IEEE Trans Automat Contr 1974;19:716-23.CrossRef
22.
Diamond GA, Staniloff HM, Forrester JS, Pollock BH, Swan HJ. Computer-assisted diagnosis in the noninvasive evaluation of patients with suspected coronary artery disease. J Am Coll Cardiol 1983;1:444-55.PubMedCrossRef
23.
Amanullah AM, Berman DS, Erel J, Kiat H, Cohen I, Germano G, et al. Incremental prognostic value of adenosine myocardial perfusion single-photon emission computed tomography in women with suspected coronary artery disease. Am J Cardiol 1998;82:725-30.PubMedCrossRef
24.
Lapeyre AC 3rd, Poornima IG, Miller TD, Hodge DO, Christian TF, Gibbons RJ. The prognostic value of pharmacologic stress myocardial perfusion imaging in patients with permanent pacemakers. J Nucl Cardiol 2005;12:37-42.PubMedCrossRef
25.
Wagdy HM, Hodge D, Christian TF, Miller TD, Gibbons RJ. Prognostic value of vasodilator myocardial perfusion imaging in patients with left bundle-branch block. Circulation 1998;97:1563-70.PubMed
26.
Leslie WD, Tully SA, Yogendran MS, Ward LM, Nour KA, Metge CJ. Prognostic value of automated quantification of 99mTc-sestamibi myocardial perfusion imaging. J Nucl Med 2005;46:204-11.PubMed
27.
Muramatsu T, Nishimura S, Yamashina A, Nishimura T. Relation between prognosis and myocardial perfusion imaging from the difference of end-point criterion for exercise stress testing: A sub-analysis of the J-ACCESS study. J Cardiol 2010;56:51-8.PubMedCrossRef
28.
Chang SM, Nabi F, Xu J, Peterson LE, Achari A, Pratt CM, et al. The coronary artery calcium score and stress myocardial perfusion imaging provide independent and complementary prediction of cardiac risk. J Am Coll Cardiol 2009;54:1872-82.PubMedCrossRef
29.
Chaitman BR, Hardison RM, Adler D, Gebhart S, Grogan M, Ocampo S, et al. The Bypass Angioplasty Revascularization Investigation 2 Diabetes randomized trial of different treatment strategies in type 2 diabetes mellitus with stable ischemic heart disease: Impact of treatment strategy on cardiac mortality and myocardial infarction. Circulation 2009;120:2529-40.PubMedCrossRef
30.
Stone GW, Rizvi A, Newman W, Mastali K, Wang JC, Caputo R, et al. Everolimus-eluting versus paclitaxel-eluting stents in coronary artery disease. N Engl J Med 2010;362:1663-74.PubMedCrossRef
Metadata
Title
Prognostic value of automated vs visual analysis for adenosine stress myocardial perfusion SPECT in patients without prior coronary artery disease: A case-control study
Authors
Yuan Xu, PhD
Ryo Nakazato, MD
Sean Hayes, MD
Rory Hachamovitch, MD
Victor Y. Cheng, MD
Heidi Gransar, MS
Romalisa Miranda-Peats, MPH
Mark Hyun, CNMT
Leslee J. Shaw, PhD
John Friedman, MD
Guido Germano, PhD
Daniel S. Berman, MD
Piotr J. Slomka, PhD
Publication date
01-12-2011
Publisher
Springer-Verlag
Published in
Journal of Nuclear Cardiology / Issue 6/2011
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-011-9449-x

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