title: [Cost-effectiveness of stress-only myocardial perfusion single photon emission computed tomography (SPECT) imaging].
abstract: Single photon emission computed tomography (SPECT) myocardial perfusion imaging is widely used for diagnosing coronary artery disease (CAD). However, SPECT costs, imaging time, and radiation exposure, limit SPECT indications.
  
  
  OBJECTIVE
  Determine whether a stress-only SPECT imaging would be enough to obtain a diagnosis of CAD improving nuclear laboratory efficiency.
  
  
  METHODS
  122 patients with unknown CAD were evaluated with stress-only SPECT imaging. In order to evaluate diagnostic accuracy and the prognostic value of the stress-only protocol, patients with abnormal SPECT underwent invasive angiography and patients with normal SPECT were followed-up during 3 years.
  
  
  RESULTS
  Diagnosis time, SPECT cost, and radiopharmaceutical dosage were significantly lower as compared with the conventional SPECT imaging protocol (30, 40 and 55%, respectively). Diagnostic accuracy and cardiac prognosis information were comparable to those obtained with the conventional imaging protocol (positive predictive value for CAD of 85% and negative predictive value for cardiac events of 97%).
  
  
  CONCLUSIONS
  In patients with intermediate risk for CAD, stress-only SPECT imaging will significantly improve nuclear laboratory efficiency, and with similar accuracy than that the one obtained with the conventional protocol.
authors.affiliation: Servicio de Cardiología Nuclear, Instituto Nacional de Cardiología Ignacio Chávez, México. vallejo.enrique@gmail.com
authors.forename: Enrique
authors.initials: E
authors.lastname: Vallejo
authors.forename: César
authors.initials: C
authors.lastname: Acevedo
authors.forename: Samuel
authors.initials: S
authors.lastname: Varela
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Alburez
authors.forename: David
authors.initials: D
authors.lastname: Bialostozky
mesh_terms: D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000191:economics*; D015899:Tomography, Emission-Computed, Single-Photon / Q000191:economics* / Q000379:methods*