COMPARISON OF SPECT AND PLANAR IMAGES OF ~(99)Tc~m-TETROFOSMIN LABELLED MYOCARDIUM USING ROC ANALYSIS

摘要

Planar and single photon emission computed tomography (SPECT) are the two main methods of image acquisition for myocardial perfusion studies. Although SPECT imaging provides superior image quality and is more sensitive than planar imaging, there is no clear benefit of this technique over planar imaging for diagnosing coronary artery disease. ~(99)Tc~m agents are best suited for SPECT imaging and ~(99)Tc~m-tetrofosmin is the newest of these agents to undergo clinical evaluation. The aim of the study was to compare, by receiver operating characteristic (ROC) curve analysis, the diagnostic accuracy of planar versus SPECT ~(99)Tc~m-tetrofosmin imaging for the detection of coronary artery disease. Seventy-five patients with known or suspected coronary artery disease were investigated. Each patient underwent stress planar and SPECT ~(99)Tc~m-tetrofosmin scans within 60 and 150 min post-injection, respectively. Coronary angiography was performed and lesions ≥50% stenosis were considered significant; a ≥75% stenosis criterion was also used for comparison. Each scintigram was given a scintigraphic score and true positive and false positive fractions were calculated at varying scintigraphic score decision thresholds using coronary arteriography as the 'gold' standard. The areas under the derived ROC curves were used as a measure of diagnostic accuracy. These indicated that SPECT ~(99)Tc~m-tetrofosmin imaging tends to enhance the detection of coronary artery disease in comparison to multiview planar imaging (0.82 versus 0.77; p = 0.34 for ≥50% stenosis and 0.81 versus 0.76; p = 0.32 for the ≥75% stenosis criterion).