Combining stress-only myocardial perfusion imaging with coronary calcium scanning as a new paradigm for initial patient work-up: An exploratory analysis

Seth Uretsky, Randy Cohen, Edgar Argulian, Kiruthika Balasundaram, Azhar Supariwala, Marjorie Subero, Samridhi Sinha, Keerthana Paladugu, E. Gordon DePuey, Alan Rozanski

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: We conducted an exploratory analysis to test whether the addition of a CAC scan can increase the applicability of stress-only SPECT-MPI.

Methods: We studied 162 patients referred for rest/stress SPECT-MPI who underwent a CAC scan. Each scan was interpreted by two readers in stepwise fashion: stress-only images; addition of clinical data; and addition of CAC data. At each step, the reader was asked if rest SPECT-MPI was necessary.

Results: Stress-only images were interpreted as normal in 62, probably normal in 42, equivocal in 15, probably abnormal in 5, and definitely abnormal in 38 patients. Rest SPECT-MPI imaging was considered necessary, in 0% of normal studies, but in 88% of probably normal studies, and 100% of those with equivocal/abnormal studies. Addition of the clinical data did not materially change this decision. Additional consideration of the CAC scan results did not influence the deemed lack of need for a rest SPECT-MPI with normal SPECT-MPI or the necessity of rest SPECT-MPI with abnormal SPECT-MPI. However, the CAC scan reduced the deemed need for a rest SPECT-MPI in 72% with a probably normal, 47% with an equivocal, and 40% of those with a probably abnormal SPECT-MPI.

Conclusions: Our exploratory analysis indicates that addition of a CAC scan to stress SPECT-MPI tends to diminish experienced readers’ deemed need to perform rest SPECT-MPI studies among patients with probably normal or borderline stress-only SPECT-MPI studies. Thus, further study appears warranted to assess the utility of using CAC scanning as a means for increasing the percent of SPECT-MPI studies that can be performed as stress-only studies.

Original languageEnglish (US)
Pages (from-to)89-97
Number of pages9
JournalJournal of Nuclear Cardiology
Volume22
Issue number1
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

Fingerprint

Myocardial Perfusion Imaging
Single-Photon Emission-Computed Tomography
Calcium

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Uretsky, Seth ; Cohen, Randy ; Argulian, Edgar ; Balasundaram, Kiruthika ; Supariwala, Azhar ; Subero, Marjorie ; Sinha, Samridhi ; Paladugu, Keerthana ; Gordon DePuey, E. ; Rozanski, Alan. / Combining stress-only myocardial perfusion imaging with coronary calcium scanning as a new paradigm for initial patient work-up : An exploratory analysis. In: Journal of Nuclear Cardiology. 2015 ; Vol. 22, No. 1. pp. 89-97.
@article{80128bae83664037a2ea3f4798e9fc92,
title = "Combining stress-only myocardial perfusion imaging with coronary calcium scanning as a new paradigm for initial patient work-up: An exploratory analysis",
abstract = "Background: We conducted an exploratory analysis to test whether the addition of a CAC scan can increase the applicability of stress-only SPECT-MPI.Methods: We studied 162 patients referred for rest/stress SPECT-MPI who underwent a CAC scan. Each scan was interpreted by two readers in stepwise fashion: stress-only images; addition of clinical data; and addition of CAC data. At each step, the reader was asked if rest SPECT-MPI was necessary.Results: Stress-only images were interpreted as normal in 62, probably normal in 42, equivocal in 15, probably abnormal in 5, and definitely abnormal in 38 patients. Rest SPECT-MPI imaging was considered necessary, in 0{\%} of normal studies, but in 88{\%} of probably normal studies, and 100{\%} of those with equivocal/abnormal studies. Addition of the clinical data did not materially change this decision. Additional consideration of the CAC scan results did not influence the deemed lack of need for a rest SPECT-MPI with normal SPECT-MPI or the necessity of rest SPECT-MPI with abnormal SPECT-MPI. However, the CAC scan reduced the deemed need for a rest SPECT-MPI in 72{\%} with a probably normal, 47{\%} with an equivocal, and 40{\%} of those with a probably abnormal SPECT-MPI.Conclusions: Our exploratory analysis indicates that addition of a CAC scan to stress SPECT-MPI tends to diminish experienced readers’ deemed need to perform rest SPECT-MPI studies among patients with probably normal or borderline stress-only SPECT-MPI studies. Thus, further study appears warranted to assess the utility of using CAC scanning as a means for increasing the percent of SPECT-MPI studies that can be performed as stress-only studies.",
author = "Seth Uretsky and Randy Cohen and Edgar Argulian and Kiruthika Balasundaram and Azhar Supariwala and Marjorie Subero and Samridhi Sinha and Keerthana Paladugu and {Gordon DePuey}, E. and Alan Rozanski",
year = "2015",
month = "1",
day = "1",
doi = "10.1007/s12350-014-9958-5",
language = "English (US)",
volume = "22",
pages = "89--97",
journal = "Journal of Nuclear Cardiology",
issn = "1071-3581",
publisher = "Springer New York",
number = "1",

}

Uretsky, S, Cohen, R, Argulian, E, Balasundaram, K, Supariwala, A, Subero, M, Sinha, S, Paladugu, K, Gordon DePuey, E & Rozanski, A 2015, 'Combining stress-only myocardial perfusion imaging with coronary calcium scanning as a new paradigm for initial patient work-up: An exploratory analysis', Journal of Nuclear Cardiology, vol. 22, no. 1, pp. 89-97. https://doi.org/10.1007/s12350-014-9958-5

Combining stress-only myocardial perfusion imaging with coronary calcium scanning as a new paradigm for initial patient work-up : An exploratory analysis. / Uretsky, Seth; Cohen, Randy; Argulian, Edgar; Balasundaram, Kiruthika; Supariwala, Azhar; Subero, Marjorie; Sinha, Samridhi; Paladugu, Keerthana; Gordon DePuey, E.; Rozanski, Alan.

In: Journal of Nuclear Cardiology, Vol. 22, No. 1, 01.01.2015, p. 89-97.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Combining stress-only myocardial perfusion imaging with coronary calcium scanning as a new paradigm for initial patient work-up

T2 - An exploratory analysis

AU - Uretsky, Seth

AU - Cohen, Randy

AU - Argulian, Edgar

AU - Balasundaram, Kiruthika

AU - Supariwala, Azhar

AU - Subero, Marjorie

AU - Sinha, Samridhi

AU - Paladugu, Keerthana

AU - Gordon DePuey, E.

AU - Rozanski, Alan

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background: We conducted an exploratory analysis to test whether the addition of a CAC scan can increase the applicability of stress-only SPECT-MPI.Methods: We studied 162 patients referred for rest/stress SPECT-MPI who underwent a CAC scan. Each scan was interpreted by two readers in stepwise fashion: stress-only images; addition of clinical data; and addition of CAC data. At each step, the reader was asked if rest SPECT-MPI was necessary.Results: Stress-only images were interpreted as normal in 62, probably normal in 42, equivocal in 15, probably abnormal in 5, and definitely abnormal in 38 patients. Rest SPECT-MPI imaging was considered necessary, in 0% of normal studies, but in 88% of probably normal studies, and 100% of those with equivocal/abnormal studies. Addition of the clinical data did not materially change this decision. Additional consideration of the CAC scan results did not influence the deemed lack of need for a rest SPECT-MPI with normal SPECT-MPI or the necessity of rest SPECT-MPI with abnormal SPECT-MPI. However, the CAC scan reduced the deemed need for a rest SPECT-MPI in 72% with a probably normal, 47% with an equivocal, and 40% of those with a probably abnormal SPECT-MPI.Conclusions: Our exploratory analysis indicates that addition of a CAC scan to stress SPECT-MPI tends to diminish experienced readers’ deemed need to perform rest SPECT-MPI studies among patients with probably normal or borderline stress-only SPECT-MPI studies. Thus, further study appears warranted to assess the utility of using CAC scanning as a means for increasing the percent of SPECT-MPI studies that can be performed as stress-only studies.

AB - Background: We conducted an exploratory analysis to test whether the addition of a CAC scan can increase the applicability of stress-only SPECT-MPI.Methods: We studied 162 patients referred for rest/stress SPECT-MPI who underwent a CAC scan. Each scan was interpreted by two readers in stepwise fashion: stress-only images; addition of clinical data; and addition of CAC data. At each step, the reader was asked if rest SPECT-MPI was necessary.Results: Stress-only images were interpreted as normal in 62, probably normal in 42, equivocal in 15, probably abnormal in 5, and definitely abnormal in 38 patients. Rest SPECT-MPI imaging was considered necessary, in 0% of normal studies, but in 88% of probably normal studies, and 100% of those with equivocal/abnormal studies. Addition of the clinical data did not materially change this decision. Additional consideration of the CAC scan results did not influence the deemed lack of need for a rest SPECT-MPI with normal SPECT-MPI or the necessity of rest SPECT-MPI with abnormal SPECT-MPI. However, the CAC scan reduced the deemed need for a rest SPECT-MPI in 72% with a probably normal, 47% with an equivocal, and 40% of those with a probably abnormal SPECT-MPI.Conclusions: Our exploratory analysis indicates that addition of a CAC scan to stress SPECT-MPI tends to diminish experienced readers’ deemed need to perform rest SPECT-MPI studies among patients with probably normal or borderline stress-only SPECT-MPI studies. Thus, further study appears warranted to assess the utility of using CAC scanning as a means for increasing the percent of SPECT-MPI studies that can be performed as stress-only studies.

UR - http://www.scopus.com/inward/record.url?scp=84928238063&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84928238063&partnerID=8YFLogxK

U2 - 10.1007/s12350-014-9958-5

DO - 10.1007/s12350-014-9958-5

M3 - Article

C2 - 25120131

AN - SCOPUS:84928238063

VL - 22

SP - 89

EP - 97

JO - Journal of Nuclear Cardiology

JF - Journal of Nuclear Cardiology

SN - 1071-3581

IS - 1

ER -