Multi-center study of inter-rater reproducibility, image quality, and diagnostic accuracy of CZT versus conventional SPECT myocardial perfusion imaging
Por:
Mansour, N, Nekolla, SG, Reyes, E, Angelidis, G, Georgoulias, P, Anagnostopoulos, C, Bravo, P, Bruno, I, Flotats, A, Fuentes-Ocampo, F, Sciagra, R, Keng, F, Kessler, L, Papathanasiou, M, Soman, P, Rischpler, C
Publicada:
1 abr 2023
Ahead of Print:
1 jul 2022
Resumen:
Background Cadmium-zinc-telluride (CZT)-based detectors exhibit higher diagnostic sensitivity in myocardial perfusion imaging (MPI) than conventional Anger-MPI for detection of coronary artery disease (CAD); however, reduced specificity and diagnostic accuracy of CZT-MPI were observed. This study aims to compare these different camera systems and to examine the degree of inter-rater reproducibility among readers with varying experience in MPI. Methods 83 patients who underwent double stress/rest examinations using both a CZT and conventional SPECT cameras within one visit were included. Anonymized and randomized MPI-images were distributed to 15 international readers using a standardized questionnaire. Subsequent coronary angiography findings of ten patients served as a reference for analysis of sensitivity and specificity. Results Image quality was significantly better in CZT-MPI with significantly lower breast attenuation (P < 0.05). CZT-MPI exhibited higher sensitivity than Anger-MPI (87.5% vs. 62.5%) and significantly reduced specificity (40% vs. 100%). Readers experienced with both camera systems had the highest inter-rater agreement indicating higher reproducibility (CZT 0.54 vs. conv. 0.49, P < 0.05). Conclusions Higher diagnostic sensitivity of CZT-MPI offers advantages in detection of CAD yet potentially of at the cost of reduced specificity, therefore it requires special training and a differentiated evaluation approach, especially for non-experienced readers with such camera systems.
Filiaciones:
Mansour, N:
Tech Univ Munich, Dept Nucl Med, Klinikum Rechts Isar, Munich, Germany
Ludwig Maximilians Univ Munchen, Dept Radiol, Univ Hosp, Munich, Germany
Nekolla, SG:
Tech Univ Munich, Dept Nucl Med, Klinikum Rechts Isar, Munich, Germany
DZHK German Ctr Cardiovasc Res, Partner Site Munich Heart Alliance, Munich, Germany
Reyes, E:
Royal Brompton & Harefield NHS Trust, London, England
Angelidis, G:
Univ Thessaly, Univ Hosp Larissa, Fac Med, Dept Nucl Med, Larisa, Greece
Georgoulias, P:
Univ Thessaly, Univ Hosp Larissa, Fac Med, Dept Nucl Med, Larisa, Greece
Anagnostopoulos, C:
BRFAA Biomed Res Fdn Acad Athens, Athens, Greece
Bravo, P:
Hosp Univ Penn, Dept Radiol, Div Nucl Med, Philadelphia, PA 19104 USA
Hosp Univ Penn, Dept Radiol, Div Cardiol, 3400 Spruce St, Philadelphia, PA 19104 USA
Hosp Univ Penn, Dept Med, Div Nucl Med, Philadelphia, PA 19104 USA
Hosp Univ Penn, Dept Med, Div Cardiol, Philadelphia, PA 19104 USA
Bruno, I:
Fdn Policlin Univ Agostino Gemelli IRCCS, Rome, Italy
Flotats, A:
Univ Autonoma Barcelona, Nucl Med Dept, Hosp Santa Creu & St Pau, Barcelona, Spain
Fuentes-Ocampo, F:
Univ Autonoma Barcelona, Nucl Med Dept, Hosp Santa Creu & St Pau, Barcelona, Spain
Sciagra, R:
Univ Florence, Dept Expt & Clin Biomed Sci Mario Serio, Florence, Italy
Keng, F:
Natl Heart Ctr, Singapore, Singapore
Kessler, L:
Univ Duisburg Essen, Univ Hosp Essen, Dept Nucl Med, Essen, Germany
Papathanasiou, M:
Univ Hosp, West German Heart & Vasc Ctr, Dept Cardiol, Essen, Germany
Soman, P:
Univ Pittsburgh, Med Ctr, Div Cardiol, Pittsburgh, PA USA
Rischpler, C:
Univ Duisburg Essen, Univ Hosp Essen, Dept Nucl Med, Essen, Germany
hybrid, All Open Access, Hybrid Gold
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