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Titolo:
COMPARATIVE DIAGNOSTIC-ACCURACY OF TL-201 AND TC-99M SESTAMIBI SPECT IMAGING (PERFUSION AND EGG-GATED SPECT) IN DETECTING CORONARY-ARTERY DISEASE IN WOMEN
Autore:
TAILLEFER R; DEPUEY EG; UDELSON JE; BELLER GA; LATOUR Y; REEVES F;
Indirizzi:
HOP HOTEL DIEU,DEPT NUCL MED,3840 ST URBAIN MONTREAL PQ H2W 1T8 CANADA ST LUKES ROOSEVELT HOSP,DEPT NUCL MED NEW YORK NY 10025 TUFTS UNIV,NEW ENGLAND MED CTR,DEPT MED BOSTON MA 02111 UNIV VIRGINIA,HLTH SCI CTR,DEPT MED CHARLOTTESVILLE VA 00000
Titolo Testata:
Journal of the American College of Cardiology
fascicolo: 1, volume: 29, anno: 1997,
pagine: 69 - 77
SICI:
0735-1097(1997)29:1<69:CDOTAT>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
METHOXY ISOBUTYL ISONITRILE; EXERCISE ELECTROCARDIOGRAPHY; SCINTIGRAPHY; IDENTIFICATION; ARTERIOGRAPHY; SENSITIVITY; PROBABILITY; STRATEGIES; TOMOGRAPHY; HISTORY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
30
Recensione:
Indirizzi per estratti:
Citazione:
R. Taillefer et al., "COMPARATIVE DIAGNOSTIC-ACCURACY OF TL-201 AND TC-99M SESTAMIBI SPECT IMAGING (PERFUSION AND EGG-GATED SPECT) IN DETECTING CORONARY-ARTERY DISEASE IN WOMEN", Journal of the American College of Cardiology, 29(1), 1997, pp. 69-77

Abstract

Objectives. This prospective study was conducted in 115 women to directly compare the sensitivity and specificity of thallium-201 (Tl-201),technetium-99m (Tc-99m) sestamibi perfusion and Tc-99m sestamibi electrocardiographic (ECG)-gated single photon emission computed tomographic (SPECT) studies for detection of coronary artery disease (CAD). Background. Data on the comparative diagnostic accuracy of Tl-201 and Tc-99m sestamibi perfusion imaging for the detection of CAD, specificallyin women, are very limited. Methods. Eighty-five patients,vith suspected CBD, scheduled for coronary angiography, and 30 volunteers,vith a pretest likelihood of less than or equal to 5% for CAD were evaluated. Within 1 week, each patient underwent Tl-201 and Tc-99m sestamibi SPECT imaging procedures (both perfusion and gated SPECT imaging). Treadmill stress testing was used in 78 patients and dipyridamole in the remaining 37 patients. All images were interpreted by three observers in a blinded manner (consensus reading). Technetium 99m sestamibi SPECT studies were read without and then with ECG gating. Technetium-99m sestamibi gated SPECT studies were used to differentiate scar tissue from soft tissue attenuation artifact. Results. The overall sensitivities for detecting greater than or equal to 50% and greater than or equal to70% stenoses were 75.0% and 84.3%, respectively, for Tl-201, and 71.9% and 80.4%, respectively, for Tc-99m sestamibi perfusion studies (p =0.48). The specificity for lesions greater than or equal to 50% was 61.9% for Tl-201 and 85.7% for Tc-99m sestamibi perfusion (p = 0.07), whereas for lesions greater than or equal to 70% it was 58.8% for Tl-201 and 82.4% for Tc-99m sestamibi perfusion (p = 0.01). When the 34 patients with a normal coronary angiogram were added to the group of 30 normal volunteers, the ''specificity'' for lesions greater than or equal to 70% was 67.2% for Tl-201, 84.4% for Tc-99m sestamibi SPECT perfusion (p = 0.02) and 92.2% for Tc-99m sestamibi gated SPECT (p = 0.0004). Conclusions. Both Tl-201 SPECT and Tc-99m sestamibi SPECT perfusion studies had a similar sensitivity for the detection of CAD in women. However, Tc-99m sestamibi SPECT perfusion imaging shows a significantlybetter specificity, which is further enhanced by the use of ECG gating.

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Documento generato il 27/11/20 alle ore 21:11:56