Computer derived transient ischemic dilation ratio for identifying extensive coronary artery disease using a CZT camera and imaging in the upright position

Transient ischemic dilation (TID) of the left ventricle (LV) has not been validated as a marker of extensive coronary artery disease (CAD) for studies using a cadmium-zinc-telluride (CZT) camera with upright imaging. TID ratios were obtained from upright stress and rest images on a CZT camera. Separ...

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Bibliographic Details
Published in:Journal of nuclear cardiology 2017-10, Vol.24 (5), p.1702-1708
Main Authors: Jameria, Zenith A., Abdallah, Mouhamad, Dwivedi, Alok, Washburn, Erica, Khan, Naseer, Khaleghi, Mahyar, Kalakota, Nischelle, Gerson, Myron C.
Format: Article
Language:English
Subjects:
Aged
Cadmium
Cadmium-zinc-telluride
Cameras
Cardiology
Cardiovascular disease
Cohort Studies
Coronary Angiography
coronary artery disease
Coronary Artery Disease - diagnostic imaging
Coronary vessels
Diagnosis, Computer-Assisted
Dilatation
Exercise Test
Female
Health risk assessment
Heart Ventricles - diagnostic imaging
Humans
Image Processing, Computer-Assisted
Imaging
Ischemia - diagnostic imaging
ischemic dilation (TID)
Male
Medicine
Medicine & Public Health
Middle Aged
Myocardial Perfusion Imaging
myocardial perfusion imaging: SPECT
Nuclear Medicine
Original Article
Predictive Value of Tests
Purines - administration & dosage
Pyrazoles - administration & dosage
Radiology
Retrospective Studies
ROC Curve
Sensitivity and Specificity
Tellurium
Tomography, Emission-Computed, Single-Photon
transient
Zinc
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Description
Summary:Transient ischemic dilation (TID) of the left ventricle (LV) has not been validated as a marker of extensive coronary artery disease (CAD) for studies using a cadmium-zinc-telluride (CZT) camera with upright imaging. TID ratios were obtained from upright stress and rest images on a CZT camera. Separate cut-off values were determined for exercise and for regadenoson stress. The cutoffs were then applied to 28 patients with extensive CAD and 101 patients without extensive CAD. With treadmill exercise, an upright TID ratio ≥1.16 provided a positive predictive value of 50% and a negative predictive value of 85.4% for the identification of extensive CAD. In the regadenoson group, an upright TID ratio of 1.29 provided a positive predictive value of 20% and a negative predictive value of 75.9%. Although not an independent predictor of extensive CAD in all subjects, in subjects with a normal upright LVEF, it provided a predictive value by receiver operating characteristics comparable to the SSS. Increased upright TID measurements on a CZT camera are associated with extensive CAD. The upright TID measurements can serve in an adjunctive role to SSS, and may be most effective in patients with a normal upright exercise LVEF.
ISSN:1071-3581
1532-6551
DOI:10.1007/s12350-016-0515-2