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- Title
CT-based attenuation correction in Tl-201 myocardial perfusion scintigraphy is less effective than non-corrected SPECT for risk stratification.
- Authors
Savvopoulos, Christos; Spyridonidis, Trifon; Papandrianos, Nikolaos; Vassilakos, Pavlos; Alexopoulos, Dimitrios; Apostolopoulos, Dimitris
- Abstract
Background: Previous studies advocate the use of attenuation correction in myocardial perfusion scintigraphy (MPS) for patient risk stratification. Methods: Six-hundred and thirty-seven unselected patients underwent Tl-201 MPS by a hybrid SPECT/CT system. Attenuation-corrected (AC) and non-corrected (NAC) images were interpreted blindly and summed stress scores (SSS) were calculated. Study endpoints were all-cause mortality and the composites of death/non-fatal acute myocardial infarction (AMI) and death/AMI/late revascularization. Results: During a follow-up of 42.3 ± 12.8 months 24 deaths, 13 AMIs and 28 revascularizations were recorded. SSS groups formed according to event rate distribution across SSS values were: 0-4, 5-13, >13 for NAC and 0-2, 3-9, >9 for AC. Kaplan-Meier functions were statistically significant between NAC SSS groups for all study endpoints. AC discriminated only between SSS 0-2 and >9 for death/AMI and between 0-2 and 3-9 for death/AMI/revascularization. In the univariate Cox regression abnormal NAC (SSS > 4) was accompanied with much higher hazards ratios than abnormal AC (SSS > 2). In the multivariate model abnormal AC yielded no significance for either endpoint whereas abnormal NAC proved independent from other covariates for the composite endpoints. Conclusion: Our results challenge the effectiveness of CT-based AC for risk stratification of patients referred for MPS.
- Subjects
COMPUTED tomography; MYOCARDIAL perfusion imaging; POSITRON emission tomography; MORTALITY; MYOCARDIAL infarction; MULTIVARIATE analysis; MYOCARDIAL revascularization
- Publication
Journal of Nuclear Cardiology, 2014, Vol 21, Issue 3, p519
- ISSN
1071-3581
- Publication type
Article
- DOI
10.1007/s12350-014-9867-7