title: Comparative accuracy of supine-only and combined supine-prone myocardial perfusion imaging in men.
abstract: Combined supine-prone myocardial perfusion imaging (CSP MPI) has been shown to reduce attenuation artifact in comparison to supine-only (SU) MPI in mixed-gender populations with varying risk for coronary artery disease (CAD), often where patients served as their own controls. However, there is limited direct comparison of these imaging strategies in men.
  
  
  
  934 male patients underwent CSP or SU MPI. Diagnostic certainty of interpretation was compared. Within the cohort, 116 were referred for left heart catheterization (LHC) to assess for CAD. Sensitivity, specificity, and area under the curve (AUC) were compared with additional analysis based on body mass index (BMI).
  
  
  
  597 patients completed the SU protocol and 337 patients completed the CSP protocol. Equivocal studies were seen more frequently in the SU group (13%) than in the CSP group (4%, P < .001). At catheterization, the specificity for CSP MPI of 70% was higher than 40% for SU MPI (P = .032). The CSP AUC (0.80 ± 0.06) was significantly larger than SU AUC (0.57 ± 0.05, P = .004). CSP specificity was significantly higher in obese patients.
  
  
  
  CSP MPI increases diagnostic certainty and improves test accuracy for CAD detection in men with CAD risk factors, especially obese patients, compared to SU MPI.
authors.affiliation: Malcom Randall VA Medical Center, 1600 SW Archer Road, Gainesville, FL, 32606, USA. vicente.taasan@va.gov.|Lake City VA Medical Center, Lake City, FL, USA. vicente.taasan@va.gov.
authors.forename: Vicente
authors.initials: V
authors.lastname: Taasan
authors.affiliation: Malcom Randall VA Medical Center, 1600 SW Archer Road, Gainesville, FL, 32606, USA.|Lake City VA Medical Center, Lake City, FL, USA.|University of Florida College of Medicine, Gainesville, FL, USA.
authors.forename: Anita
authors.initials: A
authors.lastname: Wokhlu
authors.affiliation: Malcom Randall VA Medical Center, 1600 SW Archer Road, Gainesville, FL, 32606, USA.|Lake City VA Medical Center, Lake City, FL, USA.
authors.forename: Michael V
authors.initials: MV
authors.lastname: Taasan
authors.affiliation: LeHigh Valley Health Network, Allentown, PA, USA.
authors.forename: Raman S
authors.initials: RS
authors.lastname: Dusaj
authors.affiliation: Malcom Randall VA Medical Center, 1600 SW Archer Road, Gainesville, FL, 32606, USA.|Lake City VA Medical Center, Lake City, FL, USA.|University of Florida College of Medicine, Gainesville, FL, USA.
authors.forename: Ajay
authors.initials: A
authors.lastname: Mehta
authors.affiliation: Malcom Randall VA Medical Center, 1600 SW Archer Road, Gainesville, FL, 32606, USA.|Lake City VA Medical Center, Lake City, FL, USA.|University of Florida College of Medicine, Gainesville, FL, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Kraft
authors.affiliation: Malcom Randall VA Medical Center, 1600 SW Archer Road, Gainesville, FL, 32606, USA.|Lake City VA Medical Center, Lake City, FL, USA.|University of Florida College of Medicine, Gainesville, FL, USA.
authors.forename: David
authors.initials: D
authors.lastname: Winchester
authors.affiliation: Malcom Randall VA Medical Center, 1600 SW Archer Road, Gainesville, FL, 32606, USA.|Lake City VA Medical Center, Lake City, FL, USA.|University of Florida College of Medicine, Gainesville, FL, USA.
authors.forename: David
authors.initials: D
authors.lastname: Wymer
mesh_terms: D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / Q000379:methods / Q000706:statistics & numerical data*; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D008297:Male; D054526:Men's Health; D055414:Myocardial Perfusion Imaging / Q000379:methods / Q000706:statistics & numerical data*; D009765:Obesity / Q000000981:diagnostic imaging / Q000453:epidemiology*; D056888:Patient Positioning / Q000379:methods / Q000706:statistics & numerical data*; D015995:Prevalence; D016684:Prone Position; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016683:Supine Position
keywords: Myocardial perfusion imaging; coronary artery disease; image artifacts; tetrofosmin