Application of the newly developed Japanese adenosine normal database for adenosine stress myocardial scintigraphy

作者：Harata Shingo; Isobe Satoshi^*; Morishima Itsuro; Suzuki Susumu; Tsuboi Hideyuki; Sone Takahito; Ishii Hideki; Murohara Toyoaki

来源：Annals of Nuclear Medicine, 2015, 29(8): 730-739.

DOI：10.1007/s12149-015-0995-1

• Adenosine normal database
• Japanese Society of Nuclear Medicine normal database
• Tc-99m-MIBI

The currently available Japanese normal database (NDB) in stress myocardial perfusion scintigraphy recommended by the Japanese Society of Nuclear Medicine (JSNM-NDB) is created based on the data from exercise tests. The newly developed adenosine normal database (ADS-NDB) remains to be validated for patients undergoing adenosine stress test. We tested whether the diagnostic accuracy of adenosine stress test is improved by the use of ADS-NDB (Kanazawa University).
Of 233 consecutive patients undergoing Tc-99m-MIBI adenosine stress test, 112 patients were tested. The stress/rest myocardial Tc-99m-MIBI single-photon emission computed tomography (SPECT) images were analyzed by AutoQUANT 7.2 with both ADS-NDB and JSNM-NDB. The summed stress score (SSS) and summed difference score (SDS) were calculated. The agreements of the post-stress defect severity between ADS-NDB and JSNM-NDB were assessed using a weighted kappa statistic.
In all patients, mean SSSs of all, right coronary artery (RCA), left anterior descending (LAD), and left circumflex (LCx) territories were significantly lower with ADS-NDB than those with JSNM-NDB. Mean SDSs in all, RCA, and LAD territories were significantly lower with ADS-NDB than those with JSNM-NDB. In 28 patients with significant coronary stenosis, the mean SSS in the RCA territory was significantly lower with ADS-NDB than that with JSNM-NDB. In 84 patients without ischemia, both mean SSSs and SDSs in all, RCA, LAD, and LCx territories were significantly lower with ADS-NDB than those with JSNM-NDB. Weighted kappa values of all patients, patients with significant stenosis, and patients without ischemia were 0.89, 0.83, and 0.92, respectively.
Differences were observed between results from ADS-NDB and JSNM-NDB. The diagnostic accuracy of adenosine stress myocardial perfusion scintigraphy may be improved by reducing false-positive results.

• 出版日期2015-10