Simplified normal limits and automated quantitative assessment for attenuation-corrected myocardial perfusion SPECT

J Nucl Cardiol. 2006 Sep;13(5):642-51. doi: 10.1016/j.nuclcard.2006.06.131.


Background: We aimed to compare normal limits and the detection of coronary artery disease (CAD) with attenuation-corrected (AC) and non-attenuation-corrected (NC) myocardial perfusion single photon emission computed tomography (MPS) by use of a recently improved automated quantification technique.

Methods and results: We acquired 415 rest/stress technetium 99m MPS studies on a Vertex dual-detector camera with a gadolinium 153 line source (Vantage Pro). Gender-specific NC, AC, and gender-combined AC normal limits were created from rest/stress images of 50 women and 50 men with a low likelihood of CAD (< 5%) and a median body mass index (BMI) of 30 kg/m2 in each gender group. BMI-specific normal limits (< 30 kg/m2 and > or = 30 kg/m2) were also compared. Total perfusion deficit and 17-segment summed scores in 174 patients were compared with angiography, and normalcy rates were established from 141 studies of low-likelihood patients. There were no differences between low-BMI and high-BMI normal limits for AC or NC studies. Male and female normal limits differed in 12 of 17 segments for NC stress studies and in 3 of 17 segments for AC stress studies (P < .01). The sensitivity, specificity, and normalcy rates for stenoses with 70% narrowing or greater were 89%, 73%, and 91%, respectively, for NC studies and 87%, 80%, and 95%, respectively, for AC studies (P = not significant).

Conclusion: Automated detection of CAD by AC and NC MPS demonstrated similar sensitivity, specificity, and normalcy rates. Some gender differences were noted for AC normal limits.

MeSH terms

  • Aged
  • Automation
  • Body Mass Index
  • Coronary Artery Disease / diagnosis*
  • Coronary Artery Disease / diagnostic imaging*
  • Diffusion
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Middle Aged
  • Models, Statistical
  • Myocardium / pathology
  • Perfusion
  • Reference Values
  • Sex Factors
  • Tomography, Emission-Computed, Single-Photon / methods*
  • Tomography, Emission-Computed, Single-Photon / standards*