Authors: Mohammed A Qutub Taylor Dowsley Iftikhar Ali R Glenn Wells Li Chen Terrence D Ruddy Benjamin J W Chow
Publish Date: 2013/05/25
Volume: 20, Issue: 4, Pages: 545-552
Abstract
Though myocardial perfusion imaging MPI with singlephoton emission computed tomography SPECT is an established diagnostic method equivocal studies are commonly encountered New software has been introduced that incorporates resolution recovery RR and noise regulation into the reconstruction algorithm and has been used to facilitate “halfdose” and “halftime” studies Its utility with “fulltime fulldose” acquisition has not been well studiedPatients with fulltime fulldose SPECT MPI were reviewed and those with equivocal results who subsequently underwent cardiac Rb82 positron emission tomography PET scan were identified Image reconstruction was performed with iterative reconstruction IR attenuation correction IR + AC and RR software IR + AC + RR Images were anonymized and read blindly by consensus of two experienced readers All images were qualitatively assessed and semiquantitatively graded using summed stress and summed rest scores45 patients were included 28 males age = 596 ± 99 years and the diagnostic accuracy of each of the reconstruction algorithms IR IR + AC IR + AC + RR was compared to Rb82 PET Agreement of clinical diagnosis of each SPECT reconstruction with RbPET showed incremental improvement The agreement with PET for IR + AC + RR κ = 066 CI 04540875 is significantly better than for IR κ = 022 CI 000450 P = 005 and for IR + AC κ = 032 CI 00770563 P = 03 Also IR + AC + RR improved the clinical diagnosis in 14 cases and with overall improvement of reclassification proportion of 235 compared to IR P = 01 Using PET as a reference standard ROC curves were created for IR + AC + RR IR + AC and IR which showed incremental value of the area under the curve of IR + AC + RR AUC 087 CI 076098 over IR + AC AUC 075 CI 061089 P = 078 and over IR AUC 068 CI 052084 P = 025
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