title: Quantitative evaluation of myocardial stress/rest 201TL SPECT: results of a ROI-based method in 108 patients with CHD.
abstract: ROI-based polar maps (33 ROIs) were employed to evaluate quantitatively stress/rest myocardial 201Tl SPECT in 108 patients with angiographically proven coronary heart disease (CHD) in comparison with 30 controls. Sensitivity in detecting a CHD with stenoses of greater than 50% of luminal diameter was determined versus normal regional values (+/- 2.5 SD) employing vitality (VI) and wash-out corrected redistribution (RD). The method was evaluated referring to the severity of the disease, to the number of ROIs displaying changes [(a) 1 ROI, (b) greater than 2 ROIs], to validity of VI, RD or a combination thereof, and for specificity. Wash-out values were found to depend on degree of stress individually achieved and thus were not used as a threshold criterion. Sensitivity in supply areas with old myocardial infarctions was 95% (a) and 86% (b), resp. With no infarction, it was 96% (a) and 79% (b), resp. VI in stenosis greater than 75% was more sensitive than RD. However, combined evaluation of VI and RD yielded sensitivities from 91-100% (a) and 77-94% (b), resp. for different main supply areas. In stenosis less than 50% with normal VI, RD was positive in 18-31%. Specificity turned out to be 91% (a) and 97% (b), resp. We conclude that the method presented is reliable to quantify numerically 201Tl kinetics in myocardial SPECT, aimed at detecting and describing CHD.
authors.affiliation: Department of Nuclear Medicine, University of Aachen, FRG.
authors.forename: U
authors.initials: U
authors.lastname: Buell
authors.forename: H
authors.initials: H
authors.lastname: Stirner
authors.forename: J
authors.initials: J
authors.lastname: vom Dahl
authors.forename: R
authors.initials: R
authors.lastname: Uebis
authors.forename: E
authors.initials: E
authors.lastname: Kleinhans
authors.forename: M
authors.initials: M
authors.lastname: Biedermann
authors.forename: W
authors.initials: W
authors.lastname: Grosse
authors.forename: H J
authors.initials: HJ
authors.lastname: Simon
mesh_terms: D000328:Adult; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D012016:Reference Values; D012680:Sensitivity and Specificity; D013794:Thallium Radioisotopes; D014055:Tomography, Emission-Computed
chemical_list: D013794:Thallium Radioisotopes