title: Combined quantitative supine-prone myocardial perfusion SPECT improves detection of coronary artery disease and normalcy rates in women.
abstract: 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.
authors.affiliation: Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA. slomkap@cshs.org
authors.forename: Piotr J
authors.initials: PJ
authors.lastname: Slomka
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Nishina
authors.forename: Aiden
authors.initials: A
authors.lastname: Abidov
authors.forename: Sean W
authors.initials: SW
authors.lastname: Hayes
authors.forename: John D
authors.initials: JD
authors.lastname: Friedman
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Berman
authors.forename: Guido
authors.initials: G
authors.lastname: Germano
mesh_terms: 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*
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi