Abstract 18672: Comparison of High Speed CZT SPECT MPI to Coronary Angiography
Background: Recently introduced CZT (Cadmium Zinc Telluride) SPECT cameras have the potential to lower radiation exposure to patients and speed test time, however there has been no published correlation of high speed CZT SPECT myocardial perfusion imaging (MPI) to coronary angiography.
Methods: Patients who had either a Tc-99m sestamibi or Tl-201 SPECT MPI study using a CZT camera (GE Discovery NM 530c) followed by a coronary angiogram within 2 months were included. Only patients with a history of CABG were excluded. Standard stress protocols were employed. Rest images were acquired for 5 min and stress images for 3 min and stress prone images were acquired in most patients. MPI studies and coronary angiograms were interpreted by blinded readers. A standard 17 segment model was used for MPI interpretation and coronary angiograms were interpreted for the presence of obstructive epicardial coronary artery disease (CAD) defined as ≥70% luminal narrowing. Correlation was based on the ability to diagnose obstructive CAD.
Results: Of 670 patients who underwent SPECT imaging using the CZT camera during this time period, 74 patients qualified for the correlation study (mean age 66 ± 10 yrs, 70% male, and 35% had a history of intracoronary stenting). Tc-99m was used in 77% versus Tl-201 in 23% of the studies. Exercise stress was performed in the majority (58%) of patients while vasodilator pharmacologic stress was employed in 42%. Sensitivity for detecting obstructive CAD was high at 97.4% (Table). Overall accuracy was also good at 68.9% for obstructive CAD.
Conclusions: In this first correlation study between coronary angiography and high speed CZT SPECT imaging, a high sensitivity and accuracy for detecting obstructive epicardial CAD was found for this new SPECT camera technology that is comparable to published results of conventional SPECT.
- © 2010 by American Heart Association, Inc.