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Hybrid SPECT/CT for attenuation correction of stress myocardial perfusion imaging in women

¹ Radiology, University of Michigan, Ann Arbor, Michigan

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Objectives: The objective of this study was to evaluate the diagnostic accuracy of CT based attenuation corrected (AC) SPECT myocardial perfusion imaging compared to uncorrected SPECT (NC) in female patients (pts) with angiographic correlates and low likelihood normals.

Methods: We studied 152 female pts including 94 consecutive pts with recent coronary angiography and 58 low likelihood normals. Mean weight of these pts as 86.7±24.3 Kg (range 43.6-181.8 Kg). Imaging was performed using Siemens SYMBIA-T6 SPECT-CT imaging systems (Siemens Medical Solutions, Hoffman Estates, IL) and a stress Tc-99 sestamibi protocol. Breathhold CT acquisitions were acquired at end tidal expiration, 5-7 sec. acquisition time. SPECT images were reconstructed for attenuation correction (including scatter correction and resolution recovery) using manufacturers’ software without modification. Perfusion defects were assessed by scoring severity and extent of perfusion defects in each of the three coronary artery distributions using the standard 17 segment model. For statistical purposes, p<0.05 was considered significant.

Results: Sensitivity, specificity, accuracy and normalcy all increased significantly compared to NC SPECT both by pt and by coronary territory. By pt, sensitivity increased from 78% to 93%, specificity increased from 57% to 82%, accuracy increased from 72% to 90%, and normalcy increased from 84% to 95%. Overall sensitivity by vascular territory increased significantly from 59% to 83%. Perfusion defects associated with stenosed vessels were preserved or enhanced while attenuation artifacts were usually well corrected.

Conclusions: CT based AC MPI showed significant improvements in sensitivity, specificity, accuracy and normalcy when compared to conventional NC SPECT imaging in women of widely varying body habitus.

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Corbett, J. Articles by Ficaro, E. PubMed Articles by Corbett, J. Articles by Ficaro, E.