Thallium-201 myocardial SPECT in left bundle branch block: Diagnosis of myocardial ischemia with a disease-specific reference database |
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| Authors: | Kristóf Zupán Béla Kári Géza Fontos Péter Dékány Oszkár Pártos |
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| Institution: | 1. Department of Radiation Oncology, London Health Sciences Centre, London, Ontario, Canada;2. Department of Radiation Oncology, VU Medical Center, Amsterdam, the Netherlands;3. Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, Missouri;4. Department of Clinical Oncology, St James’s Institute of Oncology, Leeds Cancer Centre, Leeds, United Kingdom;5. Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada;6. Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland;7. Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California;8. Department of Radiation Oncology, University of Yamanashi, Yamanashi, Japan;9. Department of Medical Imaging, Women’s College Hospital, Toronto, Ontario, Canada;10. Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas;11. Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio;1. Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;2. Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China;3. Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, Henan, China;4. Department of Breast Surgery, Xinmi Maternal and Child Health Care Hospital, Xinmi, Henan, China;5. Department of Preventive Medicine, Changzhi Medical College, Changzhi, Shanxi, China;6. Department of Breast Surgery, Zezhou Maternal and Child Health Care Hospital, Zezhou, Shanxi, China;7. Department of Ultrasound, Jungar Banner Maternal and Child Care Service Centre, Jungar, Inner Mongolia, China;8. Department of Women Health, Chongzhou Maternal & Child Health Care Hospital, Chongzhou, Sichuan, China;9. Physical Examination Center, Mianyang Maternal & Child Health Care Hospital, Mianyang Children''s Hospital, Mianyang, Sichuan, China;10. School of Public Health, Dalian Medical University, Dalian, Liaoning, China;11. Department of Women Health, Dalian Women and Children''s Medical Group, Dalian, Liaoning, China |
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| Abstract: | Background The aim of this study was to assess the value of a myocardial perfusion single photon emission computed tomography (SPECT)
reference file for patients with left bundle branch block (LBBB).
Methods and Results Tl-201 stress-redistribution myocardial perfusion SPECT studies of patients with complete, permanent LBBB were reviewed retrospectively.
To develop a reference database, 18 patients with a low likelihood of coronary artery disease (CAD) were selected. Left ventricular
regional average and standard deviation (SD) values of the reference file images were calculated. The diagnostic performance
was tested on perfusion images of 49 patients with LBBB, undergoing both scintigraphic and coronary angiographic evaluation,
and was compared with a commercial quantitative analysis system using a general reference database. The LBBB reference file
performed significantly better in detecting epicardial CAD than did the general reference database (receiver operating characteristic
area under the curve 0.835 ± 0.06 vs 0.580 ± 0.08, p < .01). Disease localization also was improved significantly in the territory
of the left anterior descending and of the right coronary arteries.
Conclusions The use of a reference file of patients with LBBB and a low likelihood of CAD aids the detection and the localization of myocardial
ischemia on Tl-201 myocardial SPECT images of this patient group.
The authors thank Professor Mátyás Keltai MD and István Szilvási MD for valuable discussions. The authors also thank József
Turák (Mediso Ltd., Budapest, Hungary) for providing technical information on the Interview image processing system. |
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| Keywords: | Myocardial perfusion imaging SPECT left bundle branch block coronary artery disease image processing reference database |
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