Validierung der Myokard-SPECT mit Technetium-99m-Sestamibi und der Drei-Kopf-Gammakamera (MSP 3)durch ROC-Analyse

SUBJECT: The studys objective was to validate the use of Technetium-99m-labled Sestamibi for a computer-assisted interpretation of myocardial perfusion SPECT studies. The automatic quantitatively assessment program was developed in 1995 and was not been validated with the three-head-gamma camera system (Siemens Multi-SPECT 3) yet. This camera system is used in the department of nuclear medicine. METHODS: The results of exercise rest Sestamibi myocardial tomography were compared in 298 patients with suspected or known CAD who underwent Sestamibi myocardial perfusion SPECT and coronary angiography within a 3 month period between January 1998 and December 2000. Tomographic imaging was performed with a three head rotating gamma camera (MSP 3). People were excluded with early coronary artery bypass grafting or percutaneous transluminal coronary angioplasty. Regional tracer distribution was visually and automatically quantitatively assessed in 29 segments. For biometric analysis ROC (Receiver Operating Characteristic) curves has been generated. RESULTS: The coronary angiography survey shows 124 patients with normal coronary vessels, 68 patients with single-vessel disease, 51 patients with double-vessel disease and 55 patients with three-vessel disease. In comparison to the results of Technetium-99m-labled Sestamibi tomography with the results of angiographies, at a stenoses of the coronary arteries of 50%, an overall sensitivity and specificity of 67% was achieved. In the detection of individual coronary artery stenoses there was no significant difference between the RIVA, RCX, RCA and overall sensitivity and specificity. CONCLUSIONS: The new validation of the program of automatic quantitatively assessment of Technetium-99m-labled Sestamibi tomography with the three-head-gamma camera will improve the detection of CAD in the department of nuclear medicine