Quantitative evaluation improves specificity of myocardial perfusion SPECT in the assessment of functionally significant intermediate coronary artery stenoses: a comparative study with fractional flow reserve measurements

Şahiner, Ilgın; Akdemir, Ümit Özgür; Kocaman, Sinan Altan; Şahinarslan, Asife; Timurkaynak, Timur; Ünlü, Mustafa

doi:10.1007/s12149-012-0666-4

Cited by 10 publications

(4 citation statements)

References 30 publications

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“…Considering direct correlations between visual perfusion scores of Tl-201 MPI-IQ-SPECT and FFR, the moderately inverse correlation between rSDS and FFR was the most accurate both without and with CT-AC. These results agree with previous findings in which FFR correlated with reversible myocardial perfusion abnormalities identified by visual, [ 22 , 28 – 30 ] visual semiquantitative, [ 23 , 24 , 27 , 31 – 38 ] or automated quantitative, [ 5 , 35 , 39 ] MPI-SPECT, and the outcomes of regional myocardial perfusion reserve (MPR) assessed by quantitative dynamic SPECT. [ 40 ]…”

Section: Discussionsupporting

confidence: 92%

Diagnostic value of thallium-201 myocardial perfusion IQ-SPECT without and with computed tomography-based attenuation correction to predict clinically significant and insignificant fractional flow reserve

Tanaka

Takahashi²,

Ohashi

et al. 2017

Medicine

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Section: Discussionsupporting

confidence: 92%

Diagnostic value of thallium-201 myocardial perfusion IQ-SPECT without and with computed tomography-based attenuation correction to predict clinically significant and insignificant fractional flow reserve

Tanaka

Takahashi²,

Ohashi

et al. 2017

Medicine

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“…The degree of heterogeneity was considered low (I 2 <50%), moderate (I 2 =50%-75%), or high (I 2 >75%). 9 Per imaging technique, possible publication bias was assed graphically by drawing funnel plots and statistically via the Egger test for funnel plot asymmetry. 10 Statistical analysis was performed using R version 2.10.2 combined with the package meta, version 3.5-0 (R Foundation for Statistical Computing, Vienna, Austria) and the dedicated meta-analysis software Meta-DiSc version 1.4 (Universidad Complutense, Madrid, Spain).…”

Section: Data Synthesis and Analysismentioning

confidence: 99%

Diagnostic Accuracy of Stress Myocardial Perfusion Imaging Compared to Invasive Coronary Angiography With Fractional Flow Reserve Meta-Analysis

Takx

Blomberg

Aidi

et al. 2015

Circ: Cardiovascular Imaging

350

170

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Background— Hemodynamically significant coronary artery disease is an important indication for revascularization. Stress myocardial perfusion imaging is a noninvasive alternative to invasive fractional flow reserve for evaluating hemodynamically significant coronary artery disease. The aim was to determine the diagnostic accuracy of myocardial perfusion imaging by single-photon emission computed tomography, echocardiography, MRI, positron emission tomography, and computed tomography compared with invasive coronary angiography with fractional flow reserve for the diagnosis of hemodynamically significant coronary artery disease. Methods and Results— The meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. PubMed, EMBASE, and Web of Science were searched until May 2014. Thirty-seven studies, reporting on 4721 vessels and 2048 patients, were included. Meta-analysis yielded pooled sensitivity, pooled specificity, pooled likelihood ratios (LR), pooled diagnostic odds ratio, and summary area under the receiver operating characteristic curve. The negative LR (NLR) was chosen as the primary outcome. At the vessel level, MRI (pooled NLR, 0.16; 95% confidence interval [CI], 0.13–0.21) was performed similar to computed tomography (pooled NLR, 0.22; 95% CI, 0.12–0.39) and positron emission tomography (pooled NLR, 0.15; 95% CI, 0.05–0.44), and better than single-photon emission computed tomography (pooled NLR, 0.47; 95% CI, 0.37–0.59). At the patient level, MRI (pooled NLR, 0.14; 95% CI, 0.10–0.18) performed similar to computed tomography (pooled NLR, 0.12; 95% CI, 0.04–0.33) and positron emission tomography (pooled NLR, 0.14; 95% CI, 0.02–0.87), and better than single-photon emission computed tomography (pooled NLR, 0.39; 95% CI, 0.27–0.55) and echocardiography (pooled NLR, 0.42; 95% CI, 0.30–0.59). Conclusions— Stress myocardial perfusion imaging with MRI, computed tomography, or positron emission tomography can accurately rule out hemodynamically significant coronary artery disease and can act as a gatekeeper for invasive revascularization. Single-photon emission computed tomography and echocardiography are less suited for this purpose.

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“…This small but clinically important improvement can be under interpreted because of the subjective scoring of different nuclear medicine specialists (16) . The diagnostic performance of these software packages was discussed in several studies (1,17) .…”

Section: Discussionmentioning

confidence: 99%

Effect of Localization of Coronary Artery Lesions on Total Perfusion Deficit in Myocardial Perfusion Scintigraphy

Doğan¹,

Bayram²,

Çınaral³

et al. 2018

Kosuyolu Heart Journal

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Introduction: In the present study, we analyzed patients with stable coronary artery disease (SCAD) by quantitative myocardial perfusion scintigraphy and evaluated the effect of different coronary lesion locations on total perfusion deficit (TPD). Patients and Methods: A total of 133 consecutive patients with SCAD who underwent myocardial perfusion imaging single photon emission computed tomography (SPECT) and conventional coronary angiography according to SPECT results were included in the study. TPD was used as the automated quantification variable. Results: Of the patients, 61 had significant coronary artery disease, and 72 had normal coronary arteries. For the normal, left anterior descending artery (LAD), circumflex artery (CX), and right coronary artery (RCA) groups, the median values were 7% vs. 11% vs. 10% vs. 9%, 4% vs. 6% vs. 7% vs. 4%, and 3% vs. 5% vs. 6% vs. 3% for stress TPD (sTPD), rest TPD (rTPD), and ischemic TPD (iTPD), respectively. There was no statistically significant difference in quantitative analysis (sTPD, rTPD, and iTPD) between the LAD, CX, and RCA groups (p> 0.05). Conclusion: TPD obtained by quantitative analysis method can be used for all coronary artery lesion location.

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Quantitative evaluation improves specificity of myocardial perfusion SPECT in the assessment of functionally significant intermediate coronary artery stenoses: a comparative study with fractional flow reserve measurements

Abstract: Quantitative analysis of the myocardial perfusion SPECT increases the specificity in evaluating the significance of intermediate degree coronary lesions.

Cited by 10 publications

References 30 publications

Diagnostic value of thallium-201 myocardial perfusion IQ-SPECT without and with computed tomography-based attenuation correction to predict clinically significant and insignificant fractional flow reserve

Diagnostic value of thallium-201 myocardial perfusion IQ-SPECT without and with computed tomography-based attenuation correction to predict clinically significant and insignificant fractional flow reserve

Diagnostic Accuracy of Stress Myocardial Perfusion Imaging Compared to Invasive Coronary Angiography With Fractional Flow Reserve Meta-Analysis

Effect of Localization of Coronary Artery Lesions on Total Perfusion Deficit in Myocardial Perfusion Scintigraphy

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