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Exercise gated planar myocardial perfusion imaging using technetium-99m sestamibi for the diagnosis of coronary artery disease: an alternative to exercise tomographic imaging.

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Jamar, François [UCL] Topcuoglu, R. Cauwe, F. De Coster, Patrick [UCL] Roelants, Véronique [UCL] Beckers, Christian [UCL] Melin, Jacques [UCL]

Single-photon emission tomography (SPET) using technetium-99m labelled myocardial tracers (e.g. 99mTc-sestamibi) has become one of the most popular myocardial imaging methods for the diagnosis of coronary artery disease (CAD). This prospective study was designed to evaluate the diagnostic performance of 99mTc-sestamibi exercise gated planar myocardial imaging by comparison with both visual and quantitative analyses of SPET. The study was conducted in 115 consecutive patients with known or suspected CAD, including 54 patients with a previous myocardial infarction (MI), referred for exercise testing prior to coronary angiography. Multi-gated planar imaging and SPET were performed after bicycle exercise. The end-diastolic (ED) and SPET images were visually scored (SVi). Myocardial uptake was quantitated on SPET slices using maximum count circumferential profiles (SQu) and defect extent was measured by comparison with gender-matched data sets obtained from 27 controls (< 5% likelihood of CAD). CAD was defined as coronary artery stenosis > 50% and/or regional wall motion abnormality. The cut-off criteria for positivity of the three procedures were determined from receiver operating characteristic (ROC) curves derived from the data of patients without previous MI. The area under the ROC curves was similar for ED, SVi and SQu. This was confirmed by the analysis of sensitivity performed using the ROC curve-derived cut-off criteria, in patients with or without previous MI. SVi was more sensitive than ED in identifying the diseased vessel(s) (ED: 41% vs SVi: 80%; P < 0.0005) but ED was more specific in this respect (ED: 79% vs SVi: 61%; P < 0.0005).(ABSTRACT TRUNCATED AT 250 WORDS)

Document type Article de périodique (Journal article) – Comparative Study, Journal Article, Research Support, Non-U.S. Gov't
Access type Accès restreint
Publication date 1995
Journal information "European journal of nuclear medicine" - Vol. 22, no. 1, p. 40-8 (1995)
issn 0340-6997
Publication status Publié
Affiliation UCL - MD/MINT - Département de médecine interne
MESH Subject Adult ; Coronary Disease - radionuclide imaging ; Exercise Test ; Female ; Heart - radionuclide imaging ; Heart Catheterization ; Humans ; Image Processing, Computer-Assisted ; Male ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; ROC Curve ; Sensitivity and Specificity ; Technetium Tc 99m Sestamibi - diagnostic use ; Tomography, Emission-Computed, Single-Photon
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Bibliographic reference Jamar, François ; Topcuoglu, R. ; Cauwe, F. ; De Coster, Patrick ; Roelants, Véronique ; et. al. Exercise gated planar myocardial perfusion imaging using technetium-99m sestamibi for the diagnosis of coronary artery disease: an alternative to exercise tomographic imaging.. In: European journal of nuclear medicine, Vol. 22, no. 1, p. 40-8 (1995)
Permanent URL http://hdl.handle.net/2078.1/13388