title: Initial multicentre experience of high-speed myocardial perfusion imaging: comparison between high-speed and conventional single-photon emission computed tomography with angiographic validation.
abstract: OBJECTIVE
  High-speed (HS) single-photon emission computed tomography (SPECT) with a recently developed solid-state camera shows comparable myocardial perfusion abnormalities to those seen in conventional SPECT. We aimed to compare HS and conventional SPECT images from multiple centres with coronary angiographic findings.
  
  
  METHODS
  The study included 50 patients who had sequential conventional SPECT and HS SPECT myocardial perfusion studies and coronary angiography within 3 months. Stress and rest perfusion images were visually analysed and scored semiquantitatively using a 17-segment model by two experienced blinded readers. Global and coronary territorial summed stress scores (SSS) and summed rest scores (SRS) were calculated. Global SSS ≥3 or coronary territorial SSS ≥2 was considered abnormal. In addition the total perfusion deficit (TPD) was automatically derived. TPD >5% and coronary territorial TPD ≥3% were defined as abnormal. Coronary angiograms were analysed for site and severity of coronary stenosis; ≥50% was considered significant.
  
  
  RESULTS
  Of the 50 patients, 13 (26%) had no stenosis, 22 (44%) had single-vessel disease, 6 (12%) had double-vessel disease and 9 (18%) had triple-vessel disease. There was a good linear correlation between the visual global SSS and SRS (Spearman's ρ 0.897 and 0.866, respectively; p < 0.001). In relation to coronary angiography, the sensitivities, specificities and accuracies of HS SPECT and conventional SPECT by visual assessment were 92% (35/38), 83% (10/12) and 90% (45/50) vs. 84% (32/38), 50% (6/12) and 76% (38/50), respectively (p < 0.001). The sensitivities, specificities and accuracies of HS SPECT and conventional SPECT in relation to automated TPD assessment were 89% (31/35), 57% (8/14) and 80% (39/49) vs. 86% (31/36), 77% (10/13) and 84% (41/49), respectively.
  
  
  CONCLUSIONS
  HS SPECT allows fast acquisition of myocardial perfusion images that correlate well with angiographic findings with overall accuracy by visual assessment better than conventional SPECT. Further assessment in a larger patient population may be needed to confirm this observation.
authors.affiliation: Institute of Nuclear Medicine, University College London Hospital, 235 Euston Road, London NW1 2BU, UK. johanneneill@hotmail.com
authors.forename: Johanne
authors.initials: J
authors.lastname: Neill
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Prvulovich
authors.forename: Matthews B
authors.initials: MB
authors.lastname: Fish
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Berman
authors.forename: Piotr J
authors.initials: PJ
authors.lastname: Slomka
authors.forename: Tali
authors.initials: T
authors.lastname: Sharir
authors.forename: William H
authors.initials: WH
authors.lastname: Martin
authors.forename: Marcelo F
authors.initials: MF
authors.lastname: DiCarli
authors.forename: Jack A
authors.initials: JA
authors.lastname: Ziffer
authors.forename: Jamshed B
authors.initials: JB
authors.lastname: Bomanji
authors.forename: Dalia
authors.initials: D
authors.lastname: Shiti
authors.forename: Simona
authors.initials: S
authors.lastname: Ben-Haim
mesh_terms: D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*