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Diagnostic accuracy of gated Tc-99m sestamibi stress myocardial perfusion SPECT with combined supine and prone acquisitions to detect coronary artery disease in obese and nonobese patients

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

The diagnostic value of gated myocardial perfusion single-photon emission computed tomography (MPS) with combined supine and prone acquisitions to detect coronary artery disease (CAD) in obese and nonobese patients has not been defined.

Methods and Results

We studied 1511 patients without prior myocardial infarction or coronary revascularization who either had coronary angiography within 3 months of MPS (n = 785) or had a low pretest likelihood of CAD (n = 726). All patients underwent rest thallium 201/gated exercise or adenosine stress technetium 99m sestamibi MPS in both the supine and prone positions. According to body mass index (BMI), patients were categorized as normal weight (BMI of 18.5-24.9 kg/m2), overweight (BMI of 25.0-29.9 kg/m2), or obese (BMI >30.0 kg/m2). There were no significant differences in stress, fixed, or ischemic defects among patients in different weight categories. The sensitivity of MPS was 85%, 86%, and 89% for detecting patients with 50% or greater coronary stenosis and 89%, 91%, and 92% for detecting those with 70% or greater coronary stenosis in the normal-weight, overweight, and obese groups, respectively. Normalcy rates were nearly identical among the 3 weight groups (99%, 98%, and 99%, respectively). Multivariate logistic regression analysis further confirmed that BMI was a nonsignificant predictor for the detection of CAD. In a subset of 290 patients, automated quantitative MPS analysis confirmed that combined supine and prone MPS increased specificity (86%) in identifying CAD, without a significant reduction in sensitivity (83% for >50% stenosis and 88% for >70% stenosis).

Conclusion

The findings of this study suggest that MPS performed with gating and combined supine and prone acquisitions without attenuation correction had a similar diagnostic accuracy for the detection of CAD in normal-weight, overweight, and obese patients.

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Authors and Affiliations

  1. Department of Imaging, Division of Nuclear Medicine, Department of Medicine, Division of Cardiology, and Burns and Allen Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Room 1258, 90048, Los Angeles, Calif.

    Daniel S. Berman, Xingping Kang, Hidetaka Nishina, Piotr J. Slomka, Leslee J. Shaw, Sean W. Hayes, Ishac Cohen, John D. Friedman, James Gerlach & Guido Germano

  2. Department of Medicine, School of Medicine, University of California, 8700 Beverly Blvd, Room 1258, 90048, Los Angeles, Calif.

    Daniel S. Berman, Piotr J. Slomka, Sean W. Hayes, John D. Friedman & Guido Germano

Authors
  1. Daniel S. Berman
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  2. Xingping Kang
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  3. Hidetaka Nishina
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  4. Piotr J. Slomka
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  5. Leslee J. Shaw
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  6. Sean W. Hayes
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  7. Ishac Cohen
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  8. John D. Friedman
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  9. James Gerlach
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  10. Guido Germano
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Corresponding author

Correspondence to Daniel S. Berman.

Additional information

This work was supported in part by grants from Bristol-Myers Squibb Medical Imaging, Inc, Billerica, Mass, and Astellas Pharma US, Inc, Deerfield, Ill.

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Berman, D.S., Kang, X., Nishina, H. et al. Diagnostic accuracy of gated Tc-99m sestamibi stress myocardial perfusion SPECT with combined supine and prone acquisitions to detect coronary artery disease in obese and nonobese patients. J Nucl Cardiol 13, 191–201 (2006). https://doi.org/10.1007/BF02971243

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  • DOI: https://doi.org/10.1007/BF02971243

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