title: Simplified normal limits and automated quantitative assessment for attenuation-corrected myocardial perfusion SPECT.
abstract: BACKGROUND
  We aimed to compare normal limits and the detection of coronary artery disease (CAD) with attenuation-corrected (AC) and non-attenuation-corrected (NC) myocardial perfusion single photon emission computed tomography (MPS) by use of a recently improved automated quantification technique.
  
  
  RESULTS
  We acquired 415 rest/stress technetium 99m MPS studies on a Vertex dual-detector camera with a gadolinium 153 line source (Vantage Pro). Gender-specific NC, AC, and gender-combined AC normal limits were created from rest/stress images of 50 women and 50 men with a low likelihood of CAD (< 5%) and a median body mass index (BMI) of 30 kg/m2 in each gender group. BMI-specific normal limits (< 30 kg/m2 and > or = 30 kg/m2) were also compared. Total perfusion deficit and 17-segment summed scores in 174 patients were compared with angiography, and normalcy rates were established from 141 studies of low-likelihood patients. There were no differences between low-BMI and high-BMI normal limits for AC or NC studies. Male and female normal limits differed in 12 of 17 segments for NC stress studies and in 3 of 17 segments for AC stress studies (P < .01). The sensitivity, specificity, and normalcy rates for stenoses with 70% narrowing or greater were 89%, 73%, and 91%, respectively, for NC studies and 87%, 80%, and 95%, respectively, for AC studies (P = not significant).
  
  
  CONCLUSIONS
  Automated detection of CAD by AC and NC MPS demonstrated similar sensitivity, specificity, and normalcy rates. Some gender differences were noted for AC normal limits.
authors.affiliation: Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, Calif 90048, USA. piotr.slomka@cshs.org
authors.forename: Piotr J
authors.initials: PJ
authors.lastname: Slomka
authors.forename: Mathews B
authors.initials: MB
authors.lastname: Fish
authors.forename: Santiago
authors.initials: S
authors.lastname: Lorenzo
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Nishina
authors.forename: James
authors.initials: J
authors.lastname: Gerlach
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Berman
authors.forename: Guido
authors.initials: G
authors.lastname: Germano
mesh_terms: D000368:Aged; D001331:Automation; D015992:Body Mass Index; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D004058:Diffusion; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009206:Myocardium / Q000473:pathology; D010477:Perfusion; D012016:Reference Values; D012737:Sex Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods* / Q000592:standards*