[Clinical and prognostic value of X-ray based attenuation correction in post-stress myocardial perfusion SPECT].
OBJECTIVE
The purpose of the study was to validate the X-ray-based attenuation correction technique applied to post-stress myocardial perfusion single photon emission computed tomography (SPECT).


METHODS
Fifty-six patients with clinically suspected ischemic heart disease and no history of myocardial infarction or coronary revascularization were studied. All patients underwent a myocardial perfusion SPECT after exercise (38) or pharmacological stress (18). Mean clinical follow-up time was 18.6 months. Studies were assessed after reconstruction using the filtered back projection technique and after application of the X-ray-based attenuation correction technique, and the results obtained were related to the final clinical diagnosis.


RESULTS
Eleven uncorrected studies were normal, while 45 studies showed perfusion defects. After attenuation correction, absence of significant perfusion defects was observed in 24 cases (42.9 % of all cases), and ischemic heart disease was finally ruled out in 22 cases. A greater study normalization rate was seen in men (p = 0.048; odds ratio = 2,923), but this fact was not shown to be significantly correlated to the following variables: pre-test probability of ischemic heart disease, body mass index greater than 30, presence of cardiovascular risk factors or otherwise, and age.


CONCLUSIONS
Application of the X-ray-based attenuation correction technique would have allowed for obviating the conduct of a resting perfusion study in 42.9 % of patients without apparently changing the diagnostic safety of the test. This fact was seen more frequently in men. This method seems to be both safe and time- and cost-effective.
Ruiz Solís
S
S
Servicio de Medicina Nuclear, Hospital General de Ciudad Real, España. sruiz@sescam.jccm.es
Rodado Marina
S
S
Soriano Castrejón
A
A
Cortés Romera
M
M
Poblete García
V M
VM
García Vicente
A M
AM
Talavera Rubio
P
P
Martínez
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D016477:Artifacts; D003362:Cost-Benefit Analysis; D005080:Exercise Test / Q000191:economics; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012542:Scattering, Radiation; D015899:Tomography, Emission-Computed, Single-Photon / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data; D014965:X-Rays