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Jm, Schroeder-Tanka; Buul, Tiel-van; Ee, van der Wall; Roolker, W.; Lie, Ki; Royen, van

doi:10.1023/a:1005767823114

Cited by 18 publications

(2 citation statements)

References 11 publications

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“…Worsley et al [17] demonstrated that rest images were not required if normal imaging findings had been obtained after exercise or pharmacologic stress. This was later confirmed by Schroeder-Tanka et al [18] in a larger study. Heller et al [13] found that AC applied to studies with stress-only 99m Tc MPS significantly increased the ability to interpret studies as definitely normal or abnormal and reduced the need for rest imaging.…”

Section: Discussionsupporting

confidence: 70%

Adding attenuation corrected images in myocardial perfusion imaging reduces the need for a rest study

2013

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BackgroundThe American Society of Nuclear Cardiology and the Society of Nuclear Medicine conclude that incorporation of attenuation corrected (AC) images in myocardial perfusion scintigraphy (MPS) will improve diagnostic accuracy. The aim was to investigate the value of adding AC stress-only images for the decision whether a rest study is necessary or not.Methods1,261 patients admitted to 99mTc MPS were studied. The stress studies were interpreted by two physicians who judged each study as “no rest study necessary” or “rest study necessary”, by evaluating NC stress-only and NC + AC stress-only images. When there was disagreement between the two physicians, a third physician evaluated the studies. Thus, agreement between 2 out of 3 physicians was evaluated.ResultsThe physicians assessed 214 more NC + AC images than NC images as “no rest study necessary” (17% of the study population). The number of no-rest-study-required was significantly higher for NC + AC studies compared to NC studies (859 vs 645 cases (p < 0.0001). In the final report according to clinical routine, ischemia or infarction was reported in 23 patients, assessed as “no rest study necessary” (22 NC + AC cases; 8 NC cases), (no statistically significant difference). In 11 of these, the final report stated “suspected/possible ischemia or infarction in a small area”.ConclusionsAdding AC stress-only images to NC stress-only images reduce the number of unnecessary rest studies substantially.

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Section: Discussionsupporting

confidence: 70%

Adding attenuation corrected images in myocardial perfusion imaging reduces the need for a rest study

2013

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“…Worsley et al [4] demonstrated that rest images were not required if normal imaging findings had been obtained after exercise or pharmacologic stress. The same results have been confirmed by others [5]. Current guidelines also recommend the stress study to be performed first, since the rest study can be omitted if the stress study is interpreted as normal.…”

Section: Introductionsupporting

confidence: 78%

Nuclear medicine technologists are able to accurately determine when a myocardial perfusion rest study is necessary

Trägårdh

Johansson

Olofsson

et al. 2012

BMC Med Inform Decis Mak

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BackgroundIn myocardial perfusion scintigraphy (MPS), typically a stress and a rest study is performed. If the stress study is considered normal, there is no need for a subsequent rest study. The aim of the study was to determine whether nuclear medicine technologists are able to assess the necessity of a rest study.MethodsGated MPS using a 2-day 99mTc protocol for 121 consecutive patients were studied. Visual interpretation by 3 physicians was used as gold standard for determining the need for a rest study based on the stress images. All nuclear medicine technologists performing MPS had to review 82 training cases of stress MPS images with comments regarding the need for rest studies, and thereafter a test consisting of 20 stress MPS images. After passing this test, the nuclear medicine technologists in charge of a stress MPS study assessed whether a rest study was needed or not or if he/she was uncertain and wanted to consult a physician. After that, the physician in charge interpreted the images and decided whether a rest study was required or not.ResultsThe nuclear medicine technologists and the physicians in clinical routine agreed in 103 of the 107 cases (96%) for which the technologists felt certain regarding the need for a rest study. In the remaining 14 cases the technologists were uncertain, i.e. wanted to consult a physician. The agreement between the technologists and the physicians in clinical routine was very good, resulting in a kappa value of 0.92. There was no statistically significant difference in the evaluations made by technicians and physicians (P = 0.617).ConclusionsThe nuclear medicine technologists were able to accurately determine whether a rest study was necessary. There was very good agreement between nuclear medicine technologists and physicians in the assessment of the need for a rest study. If the technologists can make this decision, the effectiveness of the nuclear medicine department will improve.

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Myocardial perfusion SPECT and SPECT/CT in interventional cardiology

Trägårdh

Hasbak

Hesse

2018

Continuing Cardiol Educ

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Myocardial perfusion imaging with single-photon emission computed tomography (SPECT) is an important and widely used non-invasive imaging test for the diagnosis and semiquantification of myocardial ischemia. SPECT data, acquired after a stress test and at rest on a gamma camera, shows left ventricular tracer uptake during stress and at rest. The tracer distributions are proportionate to the relative, regional coronary-flow distributions, respectively. A stress-induced perfusion defect reflects myocardial ischemia, while a permanent defect, unchanged from stress to rest, indicates myocardial infarction. By ECG-gating global and regional left ventricular function can also be assessed. The three most important indications for SPECT in the setting of interventional cardiology include (1) the diagnosis of coronary artery disease in intermediate-risk patients, (2) the assessment of ischemia in patients with prior successful revascularization and recurrence of symptoms, and (3) the diagnosis of acute coronary syndrome in the emergency department. The amount of ischemia is related to the outcome of patients undergoing revascularization. It was observed that patients with an ischemic area of <10% of the left ventricle demonstrated by SPECT benefit from staying on optimal medical therapy, whereas patients with more ischemia on SPECT benefit from revascularization. Guidelines and appropriate use criteria for the indications of SPECT in relation to interventional cardiology have been published by the European Society and American College of Cardiology.Answer questions and earn CME: https://wileyhealthlearning.com/Activity2/ 6463499/Activity.aspx

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Untitled

Cited by 18 publications

References 11 publications

Adding attenuation corrected images in myocardial perfusion imaging reduces the need for a rest study

Adding attenuation corrected images in myocardial perfusion imaging reduces the need for a rest study

Nuclear medicine technologists are able to accurately determine when a myocardial perfusion rest study is necessary

Myocardial perfusion SPECT and SPECT/CT in interventional cardiology

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