Abstract | BACKGROUND: In order to evaluate the diagnostic efficacy of the 1-day separate acquisition dual- isotope single-photon emission computed tomography (SPECT) protocol, using 201Tl for the rest and 99mTc-tetrofosmin for the stress images, a consecutive series of patients with suspected or known coronary artery disease (CAD) was studied that also underwent coronary angiography. METHODS: The results of myocardial SPECT, using a semi-quantitative visual analysis, were acquired in 123 patients and compared with the results of coronary angiography. Sensitivity and specificity were calculated, using thresholds of > or = 50 and > or = 70% stenosis. As an alternative for specificity, the normalcy rate was determined in a separate group of 87 patients with a < 5% pre-test likelihood of CAD. RESULTS: The prevalence of CAD using > or =50 and > or = 70% stenosis was 88 and 78%, respectively. The sensitivity for detection of patients with > or = 50 and > or = 70% stenosis was 94 and 97%, respectively while specificity was 62 and 59%, respectively. The high rate of false positive perfusion defects resulting in a low specificity could be explained by specific clinical issues. However, the routine assessment with additional clinical and electrocardiographic data resulted in a correct interpretation of most of the false positive perfusion defects. The positive predictive value was 92 and 85% and the negative predictive value 46 and 77%, using thresholds of > or = 50 and > or = 70% stenosis, respectively. The normalcy rate was 91%. CONCLUSION: The one-day separate acquisition rest 201Tl/stress 99mTc-tetrofosmin SPECT protocol is an efficient procedure for myocardial perfusion scintigraphy with high sensitivity for detection of CAD. Specific clinical issues caused a low value for specificity. Therefore, clinical information and knowledge of the electrocardiogram is essential for a correct interpretation of SPECT images.
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Authors | Reginald G E J Groutars, J Fred Verzijlbergen, Monique M C Tiel-van Buul, Aeilco H Zwinderman, Carl A P L Ascoop, Norbert M van Hemel, Ernst E van der Wall |
Journal | The international journal of cardiovascular imaging
(Int J Cardiovasc Imaging)
Vol. 19
Issue 3
Pg. 229-38
(Jun 2003)
ISSN: 1569-5794 [Print] United States |
PMID | 12834160
(Publication Type: Comparative Study, Evaluation Study, Journal Article)
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Chemical References |
- Organophosphorus Compounds
- Organotechnetium Compounds
- Radiopharmaceuticals
- Vasodilator Agents
- technetium tc-99m tetrofosmin
- Adenosine
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Topics |
- Adenosine
- Adult
- Aged
- Aged, 80 and over
- Cardiomyopathies
(diagnosis, epidemiology, physiopathology)
- Coronary Angiography
- Coronary Artery Disease
(diagnosis, epidemiology, physiopathology)
- Echocardiography
- Exercise Test
- False Positive Reactions
- Female
- Humans
- Male
- Middle Aged
- Organophosphorus Compounds
- Organotechnetium Compounds
- Predictive Value of Tests
- Prevalence
- Radiopharmaceuticals
- Risk Factors
- Sensitivity and Specificity
- Statistics as Topic
- Stroke Volume
(physiology)
- Tomography, Emission-Computed, Single-Photon
- Vasodilator Agents
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