CT-based attenuation correction in Tl-201 myocardial perfusion scintigraphy is less effective than non-corrected SPECT for risk stratification.
Τίτλος | CT-based attenuation correction in Tl-201 myocardial perfusion scintigraphy is less effective than non-corrected SPECT for risk stratification. |
Publication Type | Journal Article |
Year of Publication | 2014 |
Authors | Savvopoulos, C. A., Spyridonidis T., Papandrianos N., Vassilakos P. J., Alexopoulos D., & Apostolopoulos D. J. |
Journal | J Nucl Cardiol |
Volume | 21 |
Issue | 3 |
Pagination | 519-31 |
Date Published | 2014 Jun |
ISSN | 1532-6551 |
Λέξεις κλειδιά | Aged, Algorithms, Artifacts, Greece, Humans, Image Enhancement, Myocardial Perfusion Imaging, Prevalence, Prognosis, Proportional Hazards Models, Radiopharmaceuticals, Reproducibility of Results, Risk Assessment, Sensitivity and Specificity, Survival Rate, Thallium Radioisotopes, Tomography, Emission-Computed, Single-Photon, Tomography, X-Ray Computed |
Abstract | BACKGROUND: Previous studies advocate the use of attenuation correction in myocardial perfusion scintigraphy (MPS) for patient risk stratification.METHODS: Six-hundred and thirty-seven unselected patients underwent Tl-201 MPS by a hybrid SPECT/CT system. Attenuation-corrected (AC) and non-corrected (NAC) images were interpreted blindly and summed stress scores (SSS) were calculated. Study endpoints were all-cause mortality and the composites of death/non-fatal acute myocardial infarction (AMI) and death/AMI/late revascularization.RESULTS: During a follow-up of 42.3 ± 12.8 months 24 deaths, 13 AMIs and 28 revascularizations were recorded. SSS groups formed according to event rate distribution across SSS values were: 0-4, 5-13, >13 for NAC and 0-2, 3-9, >9 for AC. Kaplan-Meier functions were statistically significant between NAC SSS groups for all study endpoints. AC discriminated only between SSS 0-2 and >9 for death/AMI and between 0-2 and 3-9 for death/AMI/revascularization. In the univariate Cox regression abnormal NAC (SSS > 4) was accompanied with much higher hazards ratios than abnormal AC (SSS > 2). In the multivariate model abnormal AC yielded no significance for either endpoint whereas abnormal NAC proved independent from other covariates for the composite endpoints.CONCLUSION: Our results challenge the effectiveness of CT-based AC for risk stratification of patients referred for MPS. |
DOI | 10.1007/s12350-014-9867-7 |
Alternate Journal | J Nucl Cardiol |
PubMed ID | 24532033 |