title: Diagnostic accuracy of high-resolution attenuation-corrected Anger-camera SPECT in the detection of coronary artery disease.
abstract: BACKGROUND
  There is limited data on diagnostic accuracy of recently introduced high-resolution Anger (HRA) SPECT incorporating attenuation correction (AC), noise reduction, and resolution recovery algorithms. We therefore studied 54 consecutive patients (excluding those with prior MI or cardiomyopathy) who had HRA-AC SPECT and coronary angiography (CA) ≤ 30 days and no change in symptoms.
  
  
  METHODS
  The HRA-AC studies were acquired in 128 × 128 matrix (3.2 mm pixel) format with simultaneous Gd-153 line-source AC. Measured variables were image quality, interpretive certainty, sensitivity and specificity for any CAD, sensitivity for single- and multivessel CAD, and the influence of gender, body mass index (BMI), and stress modality.
  
  
  RESULTS
  The mean age of the patients was 66 ± 11 years with a BMI of 32 ± 7 kg·m(-2). Mean interpretive certainty score was 2.7 on a 3-point scale and mean image quality score was 3.3 on a 4-point scale. Stress perfusion defects were detected in 34 of 38 patients with obstructive CAD [sensitivity 89%, 95% confidence interval (CI) 76%-95%]. The specificity was 75% (CI 51%-90%) and overall diagnostic accuracy was 85% (CI 73%-92%). Accuracy did not differ for females vs males, for BMI ≤30 vs >30, or for pharmacologic vs exercise SPECT. Sensitivity for single-vessel disease was 88% (CI 69%-96%) and for multivessel disease was 93% (CI 69%-99%).
  
  
  CONCLUSIONS
  New Anger technology incorporating innovative improvements results in high image quality with excellent interpretive certainty and high diagnostic accuracy.
authors.affiliation: Saint-Luke's Mid America Heart Institute, 4330 Wornall Road, Suite 2000, Kansas City, MO, 64111, USA.
authors.forename: Harshal R
authors.initials: HR
authors.lastname: Patil
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Bateman
authors.forename: A Iain
authors.initials: AI
authors.lastname: McGhie
authors.forename: Eric V
authors.initials: EV
authors.lastname: Burgett
authors.forename: Staci A
authors.initials: SA
authors.lastname: Courter
authors.forename: James A
authors.initials: JA
authors.lastname: Case
authors.forename: Gary V
authors.initials: GV
authors.lastname: Heller
mesh_terms: D000368:Aged; D000465:Algorithms; D015992:Body Mass Index; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D015444:Exercise; D005080:Exercise Test; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi