Combined quantitative supine-prone myocardial perfusion SPECT improves detection of coronary artery disease and normalcy rates in women.
BACKGROUND
We sought to determine the diagnostic performance of a recently developed combined supine-prone quantification algorithm for myocardial perfusion single photon emission computed tomography (MPS) for the detection of coronary artery disease (CAD) in women.


RESULTS
Consecutive MPS scans of women without known CAD and coronary angiography within 3 months of MPS (n = 168) and with a low likelihood of CAD (n = 291) were considered. Total perfusion deficit (TPD) was automatically derived for supine (S-TPD), prone (P-TPD), and combined prone-supine (C-TPD) data sets. The low-likelihood patients were grouped by bra cup size (A/B, n = 102; C, n = 101; and D, n = 88). The areas under the receiver operator characteristic curves for S-TPD, P-TPD, and C-TPD were 0.84 +/- 0.03, 0.88 +/- 0.03, and 0.90 +/- 0.03, respectively. C-TPD had a higher specificity than S-TPD and P-TPD for identification of CAD (stenosis > or =70%) without compromising sensitivity (61%, 76%, and 94% for S-, P-, and C-TPD, respectively; P < .0005 vs S-TPD and P < .05 vs P-TPD). Normalcy rates were higher for C-TPD than for S-TPD or P-TPD.


CONCLUSIONS
Combined supine-prone quantitative MPS in women yields significantly increased specificity and normalcy rates without compromising sensitivity for the detection of CAD compared with standard analysis.
Slomka
Piotr J
PJ
Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA. slomkap@cshs.org
Nishina
Hidetaka
H
Abidov
Aiden
A
Hayes
Sean W
SW
Friedman
John D
JD
Berman
Daniel S
DS
Germano
Guido
G
D000368:Aged; D000465:Algorithms; D016477:Artifacts; D001940:Breast / Q000033:anatomy & histology; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008875:Middle Aged; D009929:Organ Size; D016684:Prone Position; D019275:Radiopharmaceuticals; D012016:Reference Values; D012680:Sensitivity and Specificity; D016683:Supine Position; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi