Portal de Periódicos da CAPES

Multicenter Trial of High-Speed Versus Conventional Single-Photon Emission Computed Tomography Imaging

2010; Elsevier BV; Volume: 55; Issue: 18 Linguagem: Inglês

10.1016/j.jacc.2010.01.028

1558-3597

Tali Sharir, Piotr J. Slomka, Sean W. Hayes, Marcelo F. DiCarli, Jack A. Ziffer, William H. Martin, Dalia Dickman, Simona Ben‐Haim, Daniel S. Berman,

Advanced MRI Techniques and Applications

This prospective, multicenter trial compared quantitative results of myocardial perfusion imaging and function using a high-speed single-photon emission computed tomography (SPECT) system with those obtained with conventional SPECT. A novel SPECT camera was shown in a pilot study to detect a similar amount of myocardial perfusion abnormality compared with conventional SPECT in one-seventh of the acquisition time. A total of 238 patients underwent myocardial perfusion imaging with conventional and high-speed SPECT at 4 U.S. centers. An additional 63 patients with a low pre-test likelihood of coronary artery disease underwent myocardial perfusion imaging with both technologies to develop method- and sex-specific normal limits. Rest/stress acquisition times were, respectively, 20/15 min and 4/2 min for conventional and high-speed SPECT. Stress and rest quantitative total perfusion deficit, post-stress left ventricular end-diastolic volume, and ejection fraction were derived for the 238 patients by the 2 methods. High-speed stress and rest total perfusion deficit correlated linearly with conventional SPECT total perfusion deficit (r = 0.95 and 0.97, respectively, p < 0.0001), with good concordance in the 3 vascular territories (kappa statistics for the left anterior descending coronary artery, left circumflex coronary artery, and right coronary artery were 0.73, 0.73, and 0.70, respectively; >90% agreement). The percentage of ischemic myocardium by both imaging modalities was significantly larger in patients with a high coronary artery disease likelihood than in those with a low and intermediate likelihood (p < 0.001). The average amount of ischemia was slightly but significantly larger by high-speed SPECT compared with conventional SPECT in high-likelihood patients (4.6 ± 4.6% vs. 3.9 ± 4.0%, respectively; p < 0.05). Post-stress ejection fraction and end-diastolic volume by the 2 methods were linearly correlated (r = 0.89 and 0.97, respectively). The high-speed SPECT technology provides quantitative measures of myocardial perfusion and function comparable to those with conventional SPECT in one-seventh of the acquisition time.