Myocardial perfusion imaging with technetium-99m sestamibi SPECT in the evaluation of coronary artery disease

Maddahi, Jamshid; Kiat, Hosen; Train, Kenneth F. Van; Prigent, F.; Friedman, John D.; Garcia, Ernest; Alazraki, Naomi P.; DePuey, E. Gordon; Nichols, Ken; Berman, Daniel S.

doi:10.1016/0002-9149(90)90613-6

Cited by 134 publications

(30 citation statements)

References 18 publications

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“…10,11 Recently, another attenuation correction method has been suggested. 12 The former utilizes electrocardiography to improve the specificity of myocardial imaging, whereas the latter uses tomography images for this purpose.…”

Section: Discussionmentioning

confidence: 99%

Predicting Breast Attenuation in Patients Undergoing Myocardial Perfusion Scintigraphy: A Digital X-Ray Study

et al. 2007

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Attenuation artifacts are the most common sources of error in myocardial single-photon emission computed tomography (SPECT) imaging. Breast artifacts are the most frequent causes of false positive planar images in female subjects. The purpose of this study was to predict breast adverse attenuation by measuring breast tissue thickness with digital x-ray. Sixty-five consecutive female patients with angina pectoris, who were referred to myocardial perfusion scintigraphy were enrolled in this study. Eighteen patients with normal perfusion imaging and normal coronary angiography composed the first group, whereas the second group consisted of 28 patients with a positive exercise electrocardiogram with anterior ischemia on myocardial perfusion imaging and greater than 50% left anterior descending artery stenosis on angiography. Nineteen patients in the third group had normal exercise electrocardiograms and normal coronary angiographies, but anterior ischemia on perfusion imaging. Digital x-ray records were obtained for measuring breast tissue thickness and Hounsfield density. The rate of breast adverse attenuation was 40% (19/47) in patients with anterior ischemia. The sensitivity and specificity of the prediction of breast adverse attenuation (lateral density less than 550 Hounsfield) were 79% and 11%, respectively. When breast attenuation for a breast thickness greater than 6 cm measured in the left anterior oblique view was predicted, the sensitivity and specificity were 79% and 93%, respectively. In conclusion, breast thickness greater than 6 cm measured from the left anterior oblique view with digital x-ray can predict breast adverse attenuation in female patients, and thereby may decrease the number of unnecessary invasive diagnostic procedures to be performed.

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Section: Discussionmentioning

confidence: 99%

Predicting Breast Attenuation in Patients Undergoing Myocardial Perfusion Scintigraphy: A Digital X-Ray Study

et al. 2007

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“…The addition of nuclear imaging agents improves accuracy; however, costs and testing time are considerably increased. 22,23 In recent years, echo-stress (dobutamine or transesophageal atrial pacing) 24,25 have received wide acceptance, but a considerable inter-and intraobserver variability in imaging interpretation dictates caution in definite diagnosis of coronary atherosclerosis in the individual patient. Other complex and expensive techniques such as electron-beam computed tomography can identify coronary atherosclerosis with accuracy similar to that we described for the echocardiographic detection of aortic valve sclerosis.…”

Section: Discussionmentioning

confidence: 99%

Association of aortic valve sclerosis and coronary artery disease in patients with severe nonischemic mitral regurgitation

Rossi

Bertagnolli

Cicoira

et al. 2003

Clinical Cardiology

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Background: The presence of aortic valve sclerosis accounts for a higher rate of ischemic events and increased cardiovascular mortality. It may reflect coronary artery disease (CAD) because of a shared pathologic background. Hypothesis: We aimed to analyze whether the presence of aortic valve sclerosis might help in identifying patients with coronary atherosclerosis among those with severe nonischemic mitral regurgitation (MR), who undergo coronary angiography before surgery for screening, and not because of suspected ischemic heart disease. Methods: In all, 84 patients (mean age 64 ± 9 years; 71% men) with mitral valve prolapse and severe regurgitation underwent echocardiography and coronary angiography. Aortic valve sclerosis was defined as focal areas of increased echogenicity and thickening of the leaflets without restriction of leaflet motion on echocardiography. Coronary artery disease was defined by the presence/absence of atherosclerotic plaques, independent of the degree of stenosis. Results: Coronary artery disease was diagnosed in 47.6% of patients with and 15.8% of those without aortic valve sclerosis (p = 0.008). On logistic regression analysis, the presence of aortic valve sclerosis predicted CAD (odds ratio 3.3,95% confidence interval 1.03‐10.5; p = 0.04) independent of age. In female patients, the risk ratio for CAD in the presence of aortic valve sclerosis was 9. Conclusions: Coronary artery atherosclerosis and aortic valve sclerosis are closely associated in patients with severe nonischemic MR.

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“…The accuracy of the two techniques to detect CAD has also been shown to be equal. (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) Advantages of using the Tc-99m agent include better image quality and the ability to simultaneously assess left ventricular function. (5,6) The prognostic signifi cance of a normal stress-redistribution Tl-201 myocardial perfusion study in patients with known or suspected CAD is well documented, showing a benign outcome in such patients over the short-and long-term, with an overall cardiac event rate of less than 1% per year.…”

Section: Introductionmentioning

confidence: 99%

The prognostic signifi cance of normal technetium-99m MIBI myocardial perfusion spect imaging over a four-year follow-up period

Neethling

Heerden

Klopper

et al. 2017

SAHJ

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Myocardial perfusion imaging with technetium-99m sestamibi SPECT in the evaluation of coronary artery disease

Cited by 134 publications

References 18 publications

Predicting Breast Attenuation in Patients Undergoing Myocardial Perfusion Scintigraphy: A Digital X-Ray Study

Predicting Breast Attenuation in Patients Undergoing Myocardial Perfusion Scintigraphy: A Digital X-Ray Study

Association of aortic valve sclerosis and coronary artery disease in patients with severe nonischemic mitral regurgitation

The prognostic signifi cance of normal technetium-99m MIBI myocardial perfusion spect imaging over a four-year follow-up period

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