Ambulatory Cardiac Single-Photon Emission Computed Tomography at the Primary Care Physician's Office

Chaptini, Nayla; Dontaraju, Venkata Satish; Concepcion, Frederman; Muradi, Hazem Al; Alyousef, Tareq; Canaval, Maria Del Pilar Aristizábal; Doukky, Rami

doi:10.1097/jac.0b013e3181f53458

Cited by 3 publications

(4 citation statements)

References 19 publications

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“…11 Thus, assuming a baseline annual mortality of 0.5% among subjects with normal MPI, we calculated that a cohort of 1,401 subjects would be needed to attain a 75% power to detect a four-fold increase in mortality rate associated with abnormal MPI after 2 years of follow-up (2-tailed a = 0.05). We targeted recruiting 1,500 subjects to allow some room for error in our assumptions.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][5] More recently, the advent of mobile, dedicated cardiac SPECT imaging instruments allowed MPI to become an ambulatory commodity available to low-volume primary care practices. 11 Although our group has shown that this practice is safe, 11 the long-term prognostic value of MPI in a primary care physician's (PCP's) office has not been demonstrated.…”

Section: Introductionmentioning

confidence: 99%

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The prognostic value of cardiac SPECT performed at the primary care physician’s office

Doukky

Frogge

Balakrishnan

et al. 2013

Journal of Nuclear Cardiology

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Background. The prognostic value of single-photon emission computed-tomography (SPECT)-myocardial perfusion imaging (MPI) is well documented. However, the utility of SPECT-MPI when performed at a low-volume primary care physician's (PCP's) office is unknown.Methods. We conducted a prospective cohort study of consecutive patients referred by their PCP to undergo a stress-MPI at the PCP's office using a mobile laboratory. Major adverse cardiovascular events (MACE) of death, myocardial infarction (MI), and coronary revascularization were prospectively tabulated using mail and telephone interviews, chart review, and social security death index.Results. One thousand three hundred ninety subjects [mean age 58 ± 13 years; 44% women] were followed for 27 ± 9 months, with a 99% complete follow-up rate. Subjects with abnormal MPI [174 (12.5%)] had significantly higher rates of all-cause mortality [5.2% vs 1.0%, P < .001], death, or MI [5.7% vs 1.5%, P = .001], and the composite of death, MI, or late revascularization (>60 days post-MPI) [12.6 vs 2.7%, P < .001]. Overall MACE risk was associated with the total perfusion abnormality burden, while the revascularization rate was related to the reversible perfusion abnormality burden.Conclusion. Contemporary SPECT-MPI performed in the setting of a PCP's office carries a robust prognostic value, similar to that reported in tertiary or large-volume practice settings. (J Nucl Cardiol 2013;20:519-28.) Key Words: SPECT AE myocardial perfusion imaging (MPI) AE prognosis AE outcome AE primary care physician (PCP)

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The prognostic value of cardiac SPECT performed at the primary care physician’s office

Doukky

Frogge

Balakrishnan

et al. 2013

Journal of Nuclear Cardiology

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“…Nonetheless, upright acquisition SPECT instruments are increasing in popularity with the emergence of mobile, dedicated cardiac cameras, commonly used in the physician's office. 6,8 Upright acquisition improves patient comfort. 9 However, this technique has implications on the rates and distribution of attenuation patterns in both men and women.…”

Section: Introductionmentioning

confidence: 99%

Soft tissue attenuation patterns in stress myocardial perfusion SPECT images: A comparison between supine and upright acquisition systems

Chawla

Rahaby

Amin

et al. 2011

Journal of Nuclear Cardiology

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“…Supine acquisition SPECT-MPI is associated with well recognized attenuation patterns. Nonetheless, upright acquisition SPECT instruments are increasing in popularity with the emergence of mobile cardiac-SPECT cameras, commonly used in the physician’s office [2]. While attenuation correction (AC] tools are not widely used in general [3], they are even less used with upright imaging systems.…”

Section: Introductionmentioning

confidence: 99%

Soft Tissue Attenuation Patterns Associated with Upright Acquisition SPECT Myocardial Perfusion Imaging: A Descriptive Study

Doukky¹,

Rahaby²,

Chawla³

et al. 2012

TOCMJ

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Background: Little is known about soft tissue attenuation artifacts when an upright patient-position SPECTmyocardial perfusion imaging (MPI) system is used. In this investigation we sought to describe the patterns and frequency of attenuation artifacts associated with this type of instruments and we explored the impact of gender and body habitus on these artifacts.Methods: In a cross-sectional study, we described the prevalence of various soft-tissue attenuation patterns in 212 normal SPECT-MPI studies acquired with an upright patient-position imaging system.Results: In these 212 normal, clinically-indicated, upright-acquisition SPECT-MPIs the attenuation patterns observed were: anterior (6.1%), inferior (63.7%) and lateral (24.1%). Though uncommon, anterior attenuation trended to being more prevalent among women [9.5% vs. 3.4%, P=0.07] and was independently associated with chest circumference. Lateral attenuation was more common among women [34.7% vs. 15.4%, p=0.001] and was strongly associated with obesity (p<0.001). Inferior attenuation was more prevalent among men than women (75.2% vs. 49.5% respectively, P<0.001).Conclusions: Soft-tissue attenuation artifacts are common in upright-acquisition SPECT-MPI. Recognizing the frequency of these attenuation patterns and their interaction with gender and body habitus is critical for the accurate interpretation of SPECT-MPI.

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Ambulatory Cardiac Single-Photon Emission Computed Tomography at the Primary Care Physician's Office

Cited by 3 publications

References 19 publications

The prognostic value of cardiac SPECT performed at the primary care physician’s office

The prognostic value of cardiac SPECT performed at the primary care physician’s office

Soft tissue attenuation patterns in stress myocardial perfusion SPECT images: A comparison between supine and upright acquisition systems

Soft Tissue Attenuation Patterns Associated with Upright Acquisition SPECT Myocardial Perfusion Imaging: A Descriptive Study

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