Evaluating the Role of Routine Prone Acquisition on Visual Evaluation of SPECT Images.
Journal of nuclear medicine technology, cilt.43, sa.4, ss.282-8, 2015 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 43 Sayı: 4
- Basım Tarihi: 2015
- Doi Numarası: 10.2967/jnmt.115.165936
- Dergi Adı: Journal of nuclear medicine technology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.282-8
- Anahtar Kelimeler: prone imaging, SPECT, myocardial perfusion
- Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Evet
Özet
Attenuation artifacts reduce our ability to evaluate perfusion of affected myocardial segments. The aim of this study was to evaluate the impact of routine prone-position image evaluation within a stepwise visual interpretation of myocardial perfusion studies. Methods: We have included 279 consecutive patients who were referred for evaluation of myocardial ischemia. All patients underwent routine electrocardiogram-gated supine SPECT imaging and non-electrocardiogram-gated prone-position SPECT imaging. Three nuclear medicine physicians interpreted the images in the following order: polar maps, supine images, raw images, motion-frozen gated images, and prone images, using a scale of 0-4. Segments with perfusion abnormalities were noted. Results: All physicians reported lower proportions of equivocal evaluations after evaluating prone images (18.3% vs. 4.7%, 19% vs. 11.1%, and 12.2% vs. 6.1%, P < 0.0001, P = 0.0077, and P = 0.0125, respectively). At the prone stage, normalcy rates were 89%, 87%, and 91%. Two physicians had significantly increased normalcy rates at the prone stage (72%-89%, P = 0.039, and 66%87%, P = 0.006). At the prone stage, a decision reversal to normal or probably normal was observed in 40% (29/72), 33% (17/51), and 43% (21/48). In men, apical, mid, and basal inferior walls and in women apical and mid parts of anterior walls were more likely to be attributed to attenuation. The 2 steps that increased normalcy rates for interpreters were the review of raw images and of prone images. Conclusion: Routine prone imaging increases interpretive certainty and interobserver agreement and changes the final evaluation in a substantial number of patients and significantly decreases the number of equivocal evaluations.