title: Comparison between dobutamine echocardiography and single-photon emission computed tomography for interpretive reproducibility.
abstract: Interpretive variability of dobutamine stress echocardiography (DSE) and stress single-photon emission computed tomography (SPECT) has been previously investigated. However, no study has directly compared the variability of these techniques in the same patient population. We directly compared the interpretive reproducibility of DSE and stress SPECT in patients undergoing both types of pharmacologic stress imaging. Before discharge, simultaneous DSE and SPECT was performed in 56 patients early after a first acute myocardial infarction. Intra- and interobserver concordances were evaluated by exact agreement and kappa statistic. Intraclass coefficient of correlation was used to assess intra- and interobserver reproducibilities of segmental score analysis. Intraobserver agreement percentages in the identification of patients with ischemia were 98% for SPECT and 91% for DSE (p = NS) and kappa values were excellent (>0.80) for both techniques. Interobserver agreement was higher (p <0.01) for SPECT (96%) than for DSE (79%). Similarly, kappa value was excellent for SPECT (0.92) and only moderate for DSE (0.56). Finally, the intraclass coefficients of correlation for intra- and interobserver reproducibilities were higher for SPECT (0.98 and 0.97, respectively) than for DSE (0.80 and 0.71, respectively; p <0.001 for both). In conclusion, after uncomplicated acute myocardial infarction, stress SPECT imaging has a better interpretive reproducibility than DSE.
authors.affiliation: Department of Biomorphological and Functional Sciences, University Federico II, Naples, Italy.
authors.forename: Adele
authors.initials: A
authors.lastname: Ferro
authors.forename: Teresa
authors.initials: T
authors.lastname: Pellegrino
authors.forename: Letizia
authors.initials: L
authors.lastname: Spinelli
authors.forename: Wanda
authors.initials: W
authors.lastname: Acampa
authors.forename: Mario
authors.initials: M
authors.lastname: Petretta
authors.forename: Alberto
authors.initials: A
authors.lastname: Cuocolo
mesh_terms: D002316:Cardiotonic Agents; D004280:Dobutamine; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D015588:Observer Variation; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D002316:Cardiotonic Agents; D019275:Radiopharmaceuticals; D004280:Dobutamine; D017256:Technetium Tc 99m Sestamibi