title: Angiographic correlation of myocardial perfusion imaging with half the radiation dose using ordered-subset expectation maximization with resolution recovery software.
abstract: BACKGROUND
  We previously described the feasibility of performing myocardial perfusion imaging (MPI) with half the technetium (Tc-99m) activity using ordered-subset expectation maximization with resolution recovery (OSEM-RR) processing. This study sought to assess the accuracy of this technique by correlating the findings with coronary angiography.
  
  
  METHODS
  Of 290 patients who underwent MPI-gated SPECT using a half dose of Tc-99m sestamibi and OSEM-RR software in 2010-2012 at a tertiary medical center, 62 were referred for invasive coronary angiography within 90 days and formed the study group. Ischemia was defined as a summed difference score (SDS) of >3 on the MPI scan. Luminal stenosis of ≥70% on invasive coronary angiography served as the reference.
  
  
  RESULTS
  Mean Tc-99m activity per study was 23.9 ± 11.5 mCi and mean effective radiation dose was 7.2 ± 3.4 mSv. MPI revealed no abnormalities in 10 patients (16.2%), myocardial infarction only in 8 patients (12.9%), and ischemia in 44 patients (71.1%). Overall sensitivity, specificity, and positive and negative predictive values for MPI compared to invasive angiography were 89.1%, 75.0%, 91.1%, and 70.5%, respectively.
  
  
  CONCLUSIONS
  MPI SPECT performed with a half dose of Tc-99m and OSEM-RR image processing correlates well with invasive angiography. (J Nucl Cardiol 2013).
authors.affiliation: Cardiology Department, Beilinson, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel.
authors.forename: Ariel
authors.initials: A
authors.lastname: Gutstein
authors.forename: Roman
authors.initials: R
authors.lastname: Navzorov
authors.forename: Alejandro
authors.initials: A
authors.lastname: Solodky
authors.forename: Israel
authors.initials: I
authors.lastname: Mats
authors.forename: Ran
authors.initials: R
authors.lastname: Kornowski
authors.forename: Nili
authors.initials: N
authors.lastname: Zafrir
mesh_terms: D000368:Aged; D000465:Algorithms; D019540:Area Under Curve; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging; D005080:Exercise Test / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D012680:Sensitivity and Specificity; D012984:Software; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
chemical_list: D017256:Technetium Tc 99m Sestamibi