Prognostic validation of a 17-segment score derived from a 20-segment score for myocardial perfusion SPECT interpretation

Berman, Daniel S.; Abidov, Aiden; Kang, Xingping; Hayes, Sean W.; Friedman, John D.; Sciammarella, Maria; Cohen, Ishac; Gerlach, James; Waechter, Parker; Germano, Guido; Hachamovitch, Rory

doi:10.1016/j.nuclcard.2004.03.033

Cited by 255 publications

(166 citation statements)

References 21 publications

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“…However, comparable results will be obtained by the 17-segment model [15]. The non-improved group included patients with normal EF, and those with relatively high EF before revascularization might not show significant increase in EF after revascularization.…”

Section: Limitationsmentioning

confidence: 69%

“…Myocardial segments were divided into 20 segments with QGS and QPS, namely six basal segments, six mid segments, six apical segments in the short-axis slices, and 2 apical segments in the mid vertical long-axis slice [14]. The 20-segment model was validated well and found to show good correlation with a 17-segment model [15]. Correspondence of coronary artery territory to segments was RCA to the apical inferior, mid and basal inferoseptal and inferior segments (5 segments); LCX to the apical, mid and basal anterolateral and inferolateral segments (6 segments); and LAD to the remaining segments covering anterior, septal and the apex (9 segments).…”

Section: Gated Spect Studymentioning

confidence: 99%

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Prediction of functional recovery after revascularization using quantitative gated myocardial perfusion SPECT: a multi-center cohort study in Japan

Nakajima

Tamaki

Kuwabara

et al. 2008

Eur J Nucl Med Mol Imaging

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Backgrounds Prediction of left ventricular functional recovery is important after myocardial infarction. The impact of quantitative perfusion and motion analyses with gated single-photon emission computed tomography (SPECT) on predictive ability has not been clearly defined in multi-center studies. Methods A total of 252 patients with recent myocardial infarction (n=74) and old myocardial infarction (n=175) were registered from 25 institutions. All patients underwent resting gated SPECT using 99m Tc-MIBI, and repeated the study after revascularization after an average follow-up period of 132±81 days. Visual and quantitative assessment of perfusion and wall motion were performed in 5040 segments. Results Non-gated segmental %uptake and end-systolic (ES) %uptake were good predictors of wall motion recovery and significantly differed between improved and non-improved groups (66±17% and 55±18%, p<0.0001 for non-gated, 64±16% and 51±17% for ES %uptake, p<0.0001). The area under the curve (AUC) of receiver-operating characteristics curve (ROC) for non-gated %uptake, ES %uptake, end-diastolic (ED) %uptake and visual perfusion defect score was 0.70, 0.71, 0.61 and 0.56, respectively. Sensitivity and specificity of %uptake were 68% and 64% for non-gated map and 80% and 52% for ES %uptake map. An optimal threshold for predicting segmental improvement was 63% for non-gated and 52% for ES %uptake values. Conclusion Segmental 99m Tc-MIBI uptake provided a useful predictor of wall motion improvement. Application of quantitative approach with non-gated and ES %uptake enhanced predictive accuracy over visual analysis particularly in a multi-center study.

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Section: Limitationsmentioning

confidence: 69%

Section: Gated Spect Studymentioning

confidence: 99%

Prediction of functional recovery after revascularization using quantitative gated myocardial perfusion SPECT: a multi-center cohort study in Japan

Nakajima

Tamaki

Kuwabara

et al. 2008

Eur J Nucl Med Mol Imaging

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“…The SPECT images were divided into 17 or 20 segments, and visual perfusion for 99m Tc-tetrofosmin uptake in individual segments was scored as follows: 0, normal; 1, mildly reduced; 2, moderately reduced; 3, severely reduced and 4, absent. 8 The scores from the 20-segment and 17-segment models were converted using the ratio of 17/20. 8 Summed stress (SSS) and rest (SRS) scores were calculated based on the stress and rest findings.…”

Section: Spect Data Analysismentioning

confidence: 99%

“…8 The scores from the 20-segment and 17-segment models were converted using the ratio of 17/20. 8 Summed stress (SSS) and rest (SRS) scores were calculated based on the stress and rest findings. The summed difference score (SDS) was defined as the difference between SSS and SRS.…”

Section: Spect Data Analysismentioning

confidence: 99%

Prognostic table for predicting major cardiac events based on J-ACCESS investigation

Nakajima¹

2008

Ann Nucl Med

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Objectives. The event risk of patients with coronary heart disease may be estimated by a large-scale prognostic database in a Japanese population. The aim of this study was to create a Heart Risk Table for predicting the major cardiac event rate. Methods. Using the J-ACCESS database created by a prognostic investigation involving 117 hospitals and >4000 patients in Japan, multivariate logistic regression analysis was performed. The major event rate over a 3-year period that included cardiac death, non-fatal myocardial infarction and severe heart failure requiring hospitalization was predicted by the logistic regression equation. The algorithm for calculating the event rate was simplified for creating tables. Results. Two tables were created to calculate cardiac risk by age, perfusion score category and ejection fraction with and without a presence of diabetes. A relative risk table comparing age-matched control subjects was also made. When the simplified tables were compared with the results from original logistic regression analysis, both risk values and relative risks agreed well (p<0.0001 for both). Conclusion. The Heart Risk Table was created for patients suspected of having ischemic heart disease and who underwent myocardial perfusion gated single-photon emission computed tomography. The validity of risk assessment using a J-ACCESS database should be validated in a future study.

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“…Visual interpretation was performed using short-, vertical long-, and horizontal long-axis tomograms and a 17-segment model as previously described. 7 Perfusion in each segment was evaluated using a 5-point scoring system. In addition, the summed stress score (SSS), the summed rest score (SRS), and the summed difference score (SDS) were calculated.…”

Section: Tl Spect Imaging and Interpretationmentioning

confidence: 99%

Coronary Vasospasm Produces Reversible Perfusion Defects Observed During Adenosine Triphosphate Stress Myocardial Single‐photon Emission Computed Tomography

Teragawa¹,

Ueda²,

Okuhara³

et al. 2008

Clinical Cardiology

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Background: Adenosine triphosphate stress thallium-201 single-photon emission computed tomography (ATP-SPECT) is useful for diagnosing coronary artery disease (CAD), although sometimes false positive results are observed. It has not been established whether a coronary spasm is responsible for the false positive findings during ATP-SPECT. Hypothesis: We investigated whether coronary spasm is one of the factors which produces reversible defects on ATP-SPECT. Methods: Eighty-six patients (mean age: 62 y; 58 men) who underwent both spasm-provocation testing by coronary angiography and ATP-SPECT, were selected for the study. Patients with coronary narrowing (>30%), myocardial infarction, or heart failure were excluded. Patients were divided into 2 groups based on whether the spasm-provocation test result was positive (vasospastic angina [VSA] group, n = 46) or negative (non-VSA group, n = 39). Results: The body mass index was lower in the VSA group than in the non-VSA group (p = 0.005). On ATP-SPECT imaging, any type of reversible defect was observed more frequently in the VSA group (68%) than in the non-VSA group (36%, p = 0.0027). Logistic regression analysis demonstrated that the presence of reversible defects was one of the factors accounting for the presence of coronary vasospasm (p = 0.0022, R 2 = 0.172). Conclusions:The findings suggest that reversible defects on ATP-SPECT imaging are frequently present in patients with coronary vasospasm. Coronary spasm may be considered as 1 of the factors, which produce reversible defects on ATP-SPECT, observed in patients with chest symptoms and angiographically normal coronary arteries.

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Prognostic validation of a 17-segment score derived from a 20-segment score for myocardial perfusion SPECT interpretation

Cited by 255 publications

References 21 publications

Prediction of functional recovery after revascularization using quantitative gated myocardial perfusion SPECT: a multi-center cohort study in Japan

Prediction of functional recovery after revascularization using quantitative gated myocardial perfusion SPECT: a multi-center cohort study in Japan

Prognostic table for predicting major cardiac events based on J-ACCESS investigation

Coronary Vasospasm Produces Reversible Perfusion Defects Observed During Adenosine Triphosphate Stress Myocardial Single‐photon Emission Computed Tomography

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