García CSE, Alva LLF, García OJR

Language: Spanish
References: 8
Page: 349-354
PDF size: 78.08 Kb.

ABSTRACT

Introduction: The optimization process of tomography techniques of Single photon emission computerized tomography (SPECT) known as attenuation correcting technique in the studies of myocardial perfusion (Gated-SPECT), is useful for reducing attenuation by soft tissues and provides clearer and more accurate images for coronary diseases diagnosis.
Objective: To evaluate usefulness of the attenuation correcting system in order to minimize devices that may appear like myocardial perfusion defects, caused by soft tissues (mammary tissue, thoracic walls, abdomen, left hemi diaphragm).
Material and method: 62 patients who were referred for myocardial perfusion SPECT with clinical diagnosis of coronary disease, were selected. Said patients were submitted to coronarygraphy within a maximum period of 3 months alter the non-invasive study. Myocardial perfusion studies interpretations with and without attenuation are compared, taking as a guideline the coronarygraphy.
Results: From final reports, an 83% of sensitivity global result was obtained, and with a specificity of 87% for non corrected images and an 80% (p = NS) sensitivity; and a 98% (p = 0.0004) specificity for images corrected with attenuation, related to the reference Standard for coronarygraphy.
Conclusion: Attenuation correcting application when performing the studies of myocardial perfusion to patients with suspected or documented coronary disease helps for a more effective and safe diagnosis of this entity.

REFERENCES

1. Lee TH, Boucher CA. Noninvasive tests in patients with suspected or stable coronary artery disease. N Engl J Med 2001; 344: 1840-5.

2. Hendel RC, García EV, Corbett JR, et al. The Value and Practice of Attenuation Correction for Myocardial Perfusion SPECT Imaging: A Joint Position Statement from the American Society of Nuclear Cardiology and the Society of Nuclear Medicine. J Nuclear Med 2002; 43: 273-80.

3. Hendel RC. Attenuation Correction: Eternal dilemma or real improvement? Quarterly J Nuclear Med and Molecular Imaging 2005; 49: 30-42.

4. Bateman TM, Cullom SJ. Attenuation Correction Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging. Seminars in Nuclear Medicine 2005; 35: 37-51.

5. Hendel RC, Berman DS, et al. Multicenter clinical trial to evaluate the efficacy of correction for photon attenuation and scatter in SPECT myocardial perfusion imaging. Circulation 1999; 21: 2742-9.

6. Heller GV, Links J, Bateman TM, Ficaro E, Cohen MC, Hendel RC. American Society of Nuclear Cardiology and Society of Nuclear Medicine joint position statement: attenuation correction of myocardial perfusion SPECT scintigraphy. J Nucl Cardiol 2004; 11(2): 229-30.

7. Klocke FJ, Baird MG, Bateman TM, Berman DS, Cerqueira MD, et al. ACC/AHA/ASNC guidelines for the clinical use of cardiac radionuclide imaging: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2003; 108: 1404-18.

8. Smith SC, Gibbons RJ, et al. American College of Cardiology/American Heart Association Guidelines for Percutaneous Coronary Intervention. Circulation 2001; 103: 3019-41.