Evaluation of the SPECT radioisotope perfusion scan in the detection of ischemic heart disease

• Autorzy: Zdanowski Paweł , Cacko Marek , Rabczenko Daniel , Kochman Janusz , Królicki Leszek
• Języki publikacji: EN

Abstrakty

EN

Objectives: The aim of the study is to determine the diagnostic value of myocardial perfusion scintigraphy (MPS) depending on the location and size of stenosis of a coronary vessel or vessels. Methods: Results of examinations of patients hospitalized in two hospital departments of the same medical facility were analyzed. Retrospective research material consisted of results obtained for 200 patients with suspected ischemic heart disease (coronary artery disease - CAD). From this group, 83 examinations were selected where results of coronary angiography and perfusion scintigraphy (MPS) were available. The following tests were used for statistical studies: t-Student, Chi2, Fisher- -Sendecor, Kruskal-Wallis and Willcoxon. The use of these tests allowed for: – determination of predictive factors favoring development of ischemic heart disease in the analyzed group of patients, – determination of sensitivity and specificity of MPS, taking the coronary examination as the “gold standard”, – assessment of usefulness of the MPS imaging depending on location of a stenosis within the main coronary vessels, – evaluation of usefulness of MPS in detection of a multivessel disease. Results: I n t he a nalyzed g roup o f p atients, a rterial h ypertension was the main factor predisposing to CAD (p = 0.016). The highest sensitivity of MPS in the diagnosis of ischemia was found in the group of patients with stenosis of the right coronary artery (RCA) (p = 0.029) and the circumflex (Cx) and marginal (MB) branches (p = 0.028). A comparative analysis was performed between the degree of narrowing of the above vessels and the degree of perfusion disorders in the MPS study. There was a correlation between the severity of ischemia in MPS and the degree of stenosis in both RCA (p = 0.011, 95% sensitivity (83.1 - 99.4 CI; negative predictive value 83.3%) and the Cx/MB complex (p = 0.044, sensitivity 94.7% ( 83.1 - 99.4 CI), negative predictive value - 83.3%). There was a correlation between the result of the MPS perfusion scan and disease of two or three coronary vessels. There was a 97% agreement between the presence of permanent or transient defects in MPS and the presence of stenosis in 2 or 3 coronary vessels exceeding 80% of the vessel lumen. In the group of patients with stenosis ranging between 50-80%, abnormal results of the MPS occurred in 41.7% of patients. Conclusion: The results confirm that myocardial perfusion scintigraphy is a very valuable screening test in patients with suspected CAD. This examination shows high sensitivity also in the group of patients with multivessel disease.

Słowa kluczowe

EN

MPS; coronarography; myocardium; SPECT; coronary artery disease

• Wydawca: Indygo Zahir Media
• Czasopismo: Inżynier i Fizyk Medyczny
• Rocznik: 2022
• Tom: Vol. 11, nr 2
• Strony: 129--135
• Opis fizyczny: Bibliogr. 36 poz., tab.

Twórcy

autor

Zdanowski Paweł

• Department of Nuclear Medicine, University Teaching Center of the Medical University of Warsaw, Warsaw, Poland

autor

Cacko Marek

• Imaging Diagnostics Department of the Mazovian Bródno Hospital, Warsaw, Poland

autor

Rabczenko Daniel

• Department of Monitoring and Analysis of Population Health, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland

autor

Kochman Janusz

• Department of Invasive Cardiology, University Clinical Center of the Medical University of Warsaw, Warsaw, Poland

autor

Królicki Leszek

• Department of Nuclear Medicine, University Teaching Center of the Medical University of Warsaw, Warsaw, Poland

Bibliografia

• 1. R. Hachamovitch, S.W. Hayes, J.D. Friedman et al.: Comparison of the Short-Term Survival Benefit Associated With Revascularization Compared With Medical Therapy in Patients With No Prior Coronary Artery Disease Undergoing Stress Myocardial Perfusion Single Photon Emission Computed Tomography, Circulation, 107, 2003, 2900-2906. doi: 10.1161/01.CIR.0000072790.23090.41.
• 2. M.P. Judkins: Percutaneous transfemoral selective coronary arteriography, Radiol. Clin. N. Am., 6, 1968, 467-492.
• 3. G. Montalescot, U. Sechtem, S. Achenbach, et al.: ESC guidelines on the management of stable coronary artery disease: The Task Force on the management of stable coronary artery disease of the European Society of Cardiology, Eur. Heart J., 34, 2013, 2949-3003. doi: 10.1093/eurheartj/eht296.
• 4. A. Baqi, I. Ahmed, B. Nagher: Multi vessel coronary artery disease presenting as a false negative myocardial perfusion imaging and true positive exercise tolerance test: A case of balanced ischemia, Cureus, 12, 2020, e11321.
• 5. C. Harisankar, B.R. Mittal, Kamaleshwaran K. et al.: Role of myocardial perfusion scintigraphy post invasive coronary angiography in patients with Myocardial Infarction, Indian J. Nucl. Med., 25, 2010, 53-56.
• 6. V. Dilsizian, J.A. Panza, R.O. Bonow: Myocardial perfusion imaging in hypertrophic cardiomyopathy. JACC Cardiovasc, Imaging, 3, 2010, 1078-1080.
• 7. M.S. Alqarni, Z.M. Bukhari, A.W. Abukhodair, et al.: Diagnostic Value of Single-Photon Emission Tomography Stress Test in Patients With Suspected Coronary Artery Disease in Saudi Arabia, Cureus, 13(10), 2021, e19071, DOI 10.7759/cureus.19071.
• 8. R. Nakanishi, H. Gransar, P. Slomka et al.: Predictors of High Risk Coronary Artery Disease In Subjects with Normal SPECT Myocardial Perfusion Imaging, J Nucl Cardiol., 23(3), 2016, 530-541, doi:10.1007/s12350-015-0150-3.
• 9. B. Sun, Z. Chen, Q. Duan, et al.: A direct comparison of 3 T contrastenhanced whole-heart coronary cardiovascular magnetic resonance angiography to dual-source computed tomography angiography for detection of coronary artery stenosis: a single-center experience, Journal of Cardiovascular Magnetic Resonance, 2020, https://doi.org/10.1186/s12968-020-00630-2.
• 10. P. Ammann, B. Naegeli, H. Rickli, et al.: Characteristics of Patients with Abnormal Stress Technetium Tc 99m SestamibiSPECT Studies without Significant Coronary Artery Diameter Stenoses, Clin. Cardiol., 26, 2003, 521-524.
• 11. F.J.T. Wackers, R. Soufer, B.L. Zaret: Heart Disease: A Textbook of Cardio-vascular Medicine, 5th ed., (Ed. E Braunwald), 273-316. Philadelphia: W.B. Saunders, 19972.
• 12. B.L. Zaret, F.J. Wackers: Medical progress: Nuclear cardiology (first of two parts), N Engl J ed., 329, 1993, 855-863.
• 13. T. Marwick, A.M. D’Hondt, T. Baudhuin, et al.: Optimal use of dobutamine stress for the detection and evaluationof coronary artery disease: Combination with echocardiography or scintig-raphy, or both?, J Am Coll Cardiol., 22, 1993, 159-167.
• 14. A. Elhendy, M.L. Geleijnse, R.T. van Domburg, et al.: Comparison of dobutamine stress echocardiography and technetium-99m sestamibisingle-photon emission tomography for the diagnosis of coronary artery dis-ease in hypertensive patients with and without left ventricular hypertrophy, Eur J Nucl Med., 25, 1998, 69-78.
• 15. K. Langes, B. Beuthien-Baumann, M. Lubeck, et al.: Impairment of myocardial perfusion reserve in microvas-cular angina (syndrome X): Assessment by 99mTc-MIBI-SPECT, Nuklearmedizin, 35, 1996, 193-197.
• 16. S.D. Rosen, N.G. Uren, J.C. Kaski, et al.: Coro-nary vasodilator reserve, pain perception, and sex in patients with syndrome, Circulation, 90, 1994, 50-60.
• 17. M. Emond, M.B. Mock, K.B. Davis, et al.: Long-term survival of medically treated patients in the Coronary Artery Surgery Study (CASS) Registry, Circulation, 90, 1994, 2645-2657.
• 18. T.F. Christian, T.D. Miller, KR. Bailey, et al.: Noninvasive identification of severe coronary artery disease using exercise tomographic thallium-201 imaging, Am J Cardiol., 70, 1992, 14-20.
• 19. W. Martin, A. Tweddel, I. Hutton: Balanced triple-vessel disease: enhanced detection by estimated myocardial thallium uptake, Nucl Med Commun., 13, 1992, 149-153.
• 20. J.J. Mahmarian, T.M. Boyce, R.K. Goldberg, et al.: Quantitative exercise thallium-201 single photon emission computed tomography for the enhanced diagnosis of ischemic heart disease, J Am Coll Cardiol., 15, 1990, 318-329.
• 21. E.E. DePasquale, A.C. Nody, E.G. DePuey, et al.: Quantitative rotational thallium-201 tomography for identifying and localizing coronary artery disease, Circulation, 77, 1988, 316-327.
• 22. S.Y. Chung, K.Y. Lee, E.J. Chun, et al.: Comparison of stress perfusion MRI and SPECT for detection of myocardial ischemia in patients with angiographically proven three-vessel coronary artery disease, AJR Am J Roentgenol., 195, 2010, 356-362.
• 23. G.A. Beller, B.L. Zaret: Myocardial CT Perfusion Imagingand SPECT for the Diagnosis of Coronary Artery Disease: A Head-to-Head Comparison from the CORE320 Multicenter Diagnostic Performance Study, Radiology, 272, 2014, 2.
• 24. S.Y. Chung, K.Y. Lee, E.J. Chun et al.: Comparison of Stress Perfusion MRI and SPECT for Detection of Myocardial Ischemia in Patients With Angiographically Proven Three-Vessel Coronary Artery Disease, American Journal of Roentgenology, 195, 2010, 2.
• 25. G. Varadaraj, G.S. Chowdhary, R. Ananthakrishnan, et al.: Diagnostic Accuracy of Stress Myocardial Perfusion Imaging in Diagnosing Stable Ischemic Heart Disease, Journal of The Association of Physicians of India, 66(8), 2018, 40-44.
• 26. F. Laspas, T. Pipikos, E. Karatzis, et al.: Cardiac Magnetic Resonance versus Single-Photon Emission Computed Tomography for Detecting Coronary Artery Disease and Myocardial Ischemia: Comparison with Coronary Angiography, Diagnostics, 10, 2020, 190, doi:10.3390/diagnostics10040190.
• 27. C. Aggeli, E. Christoforatou, G. Giannopoulos, et al.: The diagnostic value of adenosine stress-contrast echocardiography for diagnosis of coronary artery disease in hypertensive patients: comparison to Tl-201 single-photon emission computed tomography, Am J Hypertens, 20, 2007, 533-538.
• 28. M.J. Budoff, M.L. Rasouli, D.M. Shavelle, et al.: Cardiac CT angiography (CTA) and nuclear myocardial perfusion imaging (MPI)-a comparison in detecting significant coronary artery disease, Acad Radiol., 14, 2007, 252-257.
• 29. A. Johansen, P.F. Hoilund-Carlsen, H.W. Christensen, et al.: Diagnostic accuracy of myocardial perfusion imaging in a study population without post-test referral bias, J Nucl Cardiol., 12, 2005, 530-537.
• 30. M. Peltier, D. Vancraeynest, A. Pasquet, et al:. Assessment of the physiologic significance of coronary disease with dipyridamole real-time myocardial contrast echocardiography. Comparison with technetium-99 m sestamibi single-photon emission computed tomography and quantitative coronary angiography, J Am Coll Cardiol., 43, 2004, 257-264.
• 31. T. Schepis, O. Gaemperli, P. Koepfli, et al.: Added value of coronary artery calcium score as an adjunct to gated SPECT for the evaluation of coronary artery disease in an intermediate-risk population, J Nucl Med., 48, 2007, 1424-1430.
• 32. D.F. Yeih, P.J. Huang, Y.L. Ho: Enhanced diagnosis of coronary artery disease in women by dobutamine thallium-201 ST-segment/heart rate slope and thallium-201 myocardial SPECT, J Formos Med Assoc., 106(10), 2007, 832-839.
• 33. J. Schwitter, C.M. Wacker, N. Wilke, et al.: MR-IMPACT II: Magnetic Resonance Imaging for Myocardial Perfusion Assessment in Coronary artery disease Trial: perfusion-cardiac magnetic resonance vs. single-photon emission computed tomography for the detection of coronary artery disease: a comparative multicentre, multivendor trial, Eur Heart J., 34(10), 2013, 775-781.
• 34. J.P. Greenwood, B.A. Herzog, J.M. Brown, et al.: Prognostic Value of Cardiovascular Magnetic Resonance and Single-Photon Emission Computed Tomography in Suspected Coronary Heart Disease: Long-Term Follow-up of a Prospective, Diagnostic Accuracy Cohort Study, Ann Intern Med., 165(1), 2016, 1-9.
• 35. J.F. Heitner, R.J. Kim, H.W. Kim, et al.: Prognostic Value of Vasodilator Stress Cardiac Magnetic Resonance Imaging: A Multicenter Study With 48 000 Patient-Years of Follow-up, JAMA Cardiol., 4(3), 2019, 256-264.
• 36. H.P. Chan, Ch.Ch. Chang, Ch. Hu, et al.: The Evaluation of Left Ventricle Ischemic Extent in Patients with Significantly Suspicious Cardiovascular Disease by 99mTc-Sestamibi Dynamic SPECT/CT and Myocardial Perfusion Imaging: A Head-to-Head Comparison, Diagnostics, 11, 2021, 1101.