Automated quantitative analysis of CZT SPECT stratifies cardiovascular risk in the obese population: Analysis of the REF
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Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA Department of Cardiac Sciences, University of Calgary, Calgary, AB, Canada Department of Nuclear Cardiology, Assuta Medical Center, Tel Aviv, Israel Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheba, Israel Division of Cardiology, Department of Medicine, and Department of Radiology, Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, NY Department of Nuclear Medicine, Oregon Heart and Vascular Institute, Sacred Heart Medical Center, Springfield, OR Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland Department of Internal Medicine, Section of Cardiovascular Medicine, Yale University, New Haven, CT Cardiovascular Imaging Technologies LLC, Kansas City, MO Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women’s Hospital, Boston, MA
Received May 29, 2020; accepted Jul 24, 2020 doi:10.1007/s12350-020-02334-7
Background. Obese patients constitute a substantial proportion of patients referred for SPECT myocardial perfusion imaging (MPI), presenting a challenge of increased soft tissue attenuation. We investigated whether automated quantitative perfusion analysis can stratify risk among different obesity categories and whether two-view acquisition adds to prognostic assessment.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12350-020-02334-7) contains supplementary material, which is available to authorized users. The authors of this article have provided a PowerPoint file, available for download at SpringerLink, which summarizes the contents of the paper and is free for re-use at meetings and presentations. Search for the article DOI on SpringerLink.com.’’
Reprint requests: Piotr J. Slomka, PhD, Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Ste. A047N, Los Angeles, CA 90048; [email protected] 1071-3581/$34.00 Copyright Ó 2020 American Society of Nuclear Cardiology.
Klein et al SPECT for risk-stratification in obese patients
Journal of Nuclear CardiologyÒ
Methods. Participants were categorized according to body mass index (BMI). SPECT MPI was assessed visually and quantified automatically; combined total perfusion deficit (TPD) was evaluated. Kaplan–Meier and Cox proportional hazard analyses were used to assess major adverse cardiac event (MACE) risk. Prognostic accuracy for MACE was also compared. Results. Patients were classified according to BMI: BMI < 30, 30 £ BMI < 35, BMI ‡ 35. In adjusted analysis, each category of increasing stress TPD was associated with increased MACE risk, except for 1% £ TPD < 5% and 5% £ TPD < 10% in patients with BMI ‡ 35. Compared to visual analysis, single-position stress TPD had higher prognostic accuracy in patients
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