Abstract 1641: Attenuation-correction Does Not Improve Quantitative Diagnostic Performance of Myocardial Perfusion SPECT in Women
BACKGROUND: Attenuation Correction (AC) for myocardial perfusion single photon emission computed tomography (MPS) had not been evaluated separately in female population despite specific considerations in this group due to breast photon attenuation. We aimed to compare the performance of AC in women using automated quantitative analysis of MPS.
METHODS: Consecutive female pts, 137 low likelihood (LLk) and 115 with coronary angiography performed within < 3 months of MPS, referred for rest/stress ECG gated Tc-99m sestamibi MPS with AC (Vantage Pro, Philips), were considered. Imaging data were evaluated for contour quality control (QC). Additional 50 female LLk studies were used to create equivalent normal limits for studies with AC and with no correction (NC). An experienced technologist (JG) blinded to the angiography and other results performed contour QC. All other processing was performed in a fully automated manner. Quantitative analysis was performed using Cedars Cardiac Suite version 2005, (QPS). All automatic segmental analysis was performed in 17-segment/5 point AHA model. Summed Stress Scores (SSS) ≥ 4 were considered abnormal. Receiver Operator Characteristics (ROC) areas-under- curve (AUC) were obtained by Analyze-It (v 1.171) statistical package.
RESULTS: CAD (≥ 70% stenosis) was present in 70/115 (61%) pts. The normalcy rates were 96% and 98% for studies with and without AC, respectively (P=NS). SSS in studies with or without AC were the same with the exception of normal patients were SSS was higher for studies with AC. The diagnostic performance of MPS with and without AC for detection of CAD is summarized in the table⇓.
Conclusions: There are no diagnostic differences between quantitative MPS analysis with or without AC in women and no gain in specificity or normalcy rates contrary to previously reported findings in general populations.