Abstract 16162: Impact of CT-Based Attenuation Correction Imaging With a High Speed Cadmium-Zinc-Telluride SPECT Myocardial Perfusion Image to Resolve Inferior Wall Attenuation
Background: Cadmium-zinc-telluride (CZT) detectors are faster and produce higher quality images as compared to conventional SPECT cameras. However, CZT camera images still have not overcome the attenuation of inferior wall as standard camera. Adding prone and CT attenuation correction (CTAC) images have been shown to improve diagnostic performance to detect ischemia of inferior wall. Utility of CT attenuation corrected myocardial perfusion image (MPI) with NM 530c is uncertain.
Methods: The study population included 83 patients (77% men; mean age 71±9 years) who underwent 1-day 99mTc-tetrofosmin pharmacologic rest/stress examination using CZT camera (GE Discovery NM 530c) a day before CAG. We diagnosed reversible perfusion defects visually on MPI (supine, prone and CTAC) as ischemia until CAG. CTAC images reconstructed using CT-based transmission data with the16-slice CT (GE Discovery NM/CT 670). Cardiac ischemia was defined as a luminal narrowing of ≧90% stenosis by CAG. In the cases of intermediate stenosis (75% stenosis), fractional flow reserve (FFR) was calculated. Per-patient sensitivity, specificity and accuracy of supine, prone and CTAC to detect inferior to lateral wall ischemia were calculated.
Results: Per-patient sensitivity, specificity, and accuracy of supine, prone and CTAC images to predict CAD in CAG were 42%, 88%, 77%, 67%, 81%, 78%, 61%, 93% and 85%, respectively (Figure).
Conclusions: Myocardial perfusion imaging with CZT device improves diagnostic performance of inferior to lateral wall ischemia adding to CTAC image.
Author Disclosures: S. Ito: None. A. Endo: None. T. Sugamori: None. N. Takahashi: None. K. Tanabe: None.
- © 2014 by American Heart Association, Inc.