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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 2/2016

01-02-2016 | Original Article

Prognostic value of normal stress-only myocardial perfusion imaging: a comparison between conventional and CZT-based SPECT

Authors: Shu Yokota, Mohamed Mouden, Jan Paul Ottervanger, Elsemiek Engbers, Siert Knollema, Jorik R. Timmer, Pieter L. Jager

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 2/2016

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Abstract

Purpose

Single photon emission computed tomography (SPECT) myocardial perfusion imaging has proven to have prognostic importance in patients with suspected stable coronary artery disease (CAD). The recently introduced ultrafast cadmium zinc telluride (CZT)-based gamma cameras have been associated with less equivocal findings and more normal interpretations, allowing stress-only imaging to be performed more often. However, it is yet unclear whether normal stress-only CZT SPECT has comparable prognostic value as normally interpreted stress-only conventional SPECT.

Methods

The study population consisted of 1,650 consecutive patients without known CAD with normal stress-only myocardial perfusion results with either conventional (n = 362) or CZT SPECT (n = 1,288). The incidence of major adverse cardiac events (MACE, all-cause death, non-fatal myocardial infarction and/or coronary revascularization) was compared between the conventional SPECT and CZT SPECT groups. Multivariable analyses using the Cox model were used to adjust for differences in baseline variables.

Results

Patients scanned with CZT were less often male (33 vs 39 %), had less often hypercholesterolaemia (41 vs 50 %) and had more often a family history of CAD (57 vs 49 %). At a median follow-up time of 37 months (interquartile range 28–45 months) MACE occurred in 68 patients. The incidence of MACE was 1.5 %/year in the CZT group, compared to 2.0 %/year in the conventional group (p = 0.08). After multivariate analyses, there was a trend to a lower incidence of MACE in the CZT SPECT group (hazard ratio 0.61, 95 % confidence interval 0.35–1.04, p = 0.07).

Conclusion

The prognostic value of normal stress-only CZT SPECT is at least comparable and may be even better than that of normal conventional stress SPECT.
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Metadata
Title
Prognostic value of normal stress-only myocardial perfusion imaging: a comparison between conventional and CZT-based SPECT
Authors
Shu Yokota
Mohamed Mouden
Jan Paul Ottervanger
Elsemiek Engbers
Siert Knollema
Jorik R. Timmer
Pieter L. Jager
Publication date
01-02-2016
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 2/2016
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-015-3192-5

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