Quantitative single photon emission computed thallium-201 tomography for detection and localization of coronary artery disease: Optimization and prospective validation of a new technique
- Cedars-Sinai Medical Center, Los Angeles, CA (USA)
One hundred eight-three men underwent stress-redistribution thallium-201 myocardial perfusion tomography. After evaluation of various preprocessing filters in a phantom study, the Butterworth filter with a frequency cutoff of 0.2 cycles/pixel, order 5 (which provided optimal filter power) was used in the back projection algorithm of the patient studies. All short-axis and apical portions of vertical long-axis images were quantified by dividing each myocardial slice into 60 equal sectors and displaying the maximal count per sector as a linear profile. In a pilot group consisting of 20 normal men (less than 5% likelihood of coronary artery disease) and 25 men with coronary artery disease (greater than or equal to 50% coronary stenosis by angiography), profiles representing the lowest observed value below the mean normal profiles provided the best threshold for defining normal limits. Abnormal portions of the patient profiles were plotted on a two-dimensional polar map. The polar map was divided into 102 sectors, and sectors with a probability of greater than or equal to 80% for disease of each one of the three major coronary arteries were clustered to represent specific coronary artery territories. Receiver operating characteristic curve analysis for defect size showed that the optimal threshold for defining a definite perfusion defect was 12% for the left anterior descending and left circumflex and 8% for the right coronary artery territories. These criteria were prospectively applied to an additional 92 patients with angiographic coronary artery disease, 18 patients with normal coronary arteriograms and 28 patients with less than 5% likelihood of coronary disease. Sensitivity, specificity and normalcy rate for overall detection of coronary disease were 96%, 56% and 86%, respectively.
- OSTI ID:
- 5050904
- Journal Information:
- Journal of the American College of Cardiology; (USA), Vol. 14:7; ISSN 0735-1097
- Country of Publication:
- United States
- Language:
- English
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DIAGNOSIS
HEART
SCINTISCANNING
SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
SENSITIVITY ANALYSIS
ALGORITHMS
CORONARIES
EXERCISE
PATIENTS
PERFUSED ORGANS
QUALITY CONTROL
SPECIFICITY
THALLIUM 201
ARTERIES
BETA DECAY RADIOISOTOPES
BLOOD VESSELS
BODY
CARDIOVASCULAR SYSTEM
COMPUTERIZED TOMOGRAPHY
CONTROL
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
EMISSION COMPUTED TOMOGRAPHY
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MATHEMATICAL LOGIC
NUCLEI
ODD-EVEN NUCLEI
ORGANS
RADIOISOTOPE SCANNING
RADIOISOTOPES
SECONDS LIVING RADIOISOTOPES
THALLIUM ISOTOPES
TOMOGRAPHY
550601* - Medicine- Unsealed Radionuclides in Diagnostics