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- Danad, Ibrahim, et al.
(författare)
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Quantitative Assessment of Myocardial Perfusion in the Detection of Significant Coronary Artery Disease Cutoff Values and Diagnostic Accuracy of Quantitative [O-15]H2O PET Imaging
- 2014
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Ingår i: Journal of the American College of Cardiology. - : Elsevier BV. - 0735-1097 .- 1558-3597. ; 64:14, s. 1464-1475
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Recent studies have demonstrated improved diagnostic accuracy for detecting coronary artery disease (CAD) when myocardial blood flow (MBF) is quantified in absolute terms, but there are no uniformly accepted cutoff values for hemodynamically significant CAD. OBJECTIVES The goal of this study was to determine cutoff values for absolute MBF and to evaluate the diagnostic accuracy of quantitative [O-15]H2O positron emission tomography (PET). METHODS A total of 330 patients underwent both quantitative [O-15]H2O PET imaging and invasive coronary angiography in conjunction with fractional flow reserve measurements. A stenosis >90% and/or fractional flow reserve <= 0.80 was considered obstructive; a stenosis <30% and/or fractional flow reserve >0.80 was nonobstructive. RESULTS Hemodynamically significant CAD was diagnosed in 116 (41%) of 281 patients who fulfilled study criteria for CAD. Resting perfusion was 1.00 +/- 0.25 and 0.92 +/- 0.23 ml/min/g in regions supplied by nonstenotic and significantly stenosed vessels, respectively (p < 0.001). During stress, perfusion increased to 3.26 +/- 1.04 ml/min/g and 1.73 +/- 0.67 ml/min/g, respectively (p < 0.001). The optimal cutoff values were 2.3 and 2.5 for hyperemic MBF and myocardial flow reserve, respectively. For MBF, these cutoff values showed a sensitivity, specificity, and accuracy for detecting significant CAD of 89%, 84%, and 86%, respectively, at a per-patient level and 87%, 85%, and 85% at a per-vessel level. The corresponding myocardial flow reserve values were 86%, 72%, and 78% (per patient) and 80%, 82%, and 81% (per vessel). Age and sex significantly affected diagnostic accuracy of quantitative PET. CONCLUSIONS Quantitative MBF measurements with the use of [O-15]H2O PET provided high diagnostic performance, but both sex and age should be taken into account.
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- Saraste, Helena, et al.
(författare)
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3D analysis of spine and chest wall form and mobility. Application of a new method to evaluate treatment outcome in pediatric spine deformities
- 2012
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- SummaryA new optical scanning method is applyed for a static and dynamic analysis of thorax and spine deformities in brace and surgically treated scoliosis patients to capture intervention dependent changes over time. The costs and additional information captured by the method is analysed.IntroductionTo evaluate the intervention dependent changes in spine and chest wall deformities, such as mobility of thorax, volume, symmetry of growth, and possible growth distorting factors are poorly known and should be studied. In patients with neuropathic spine deformities, the seat loading is of importance to enhance balanced sitting and preventing pressure problems. Quantitative methods to be used for over time comparisons need to be further developed.In adolescents the decision to treat a spine deformity is mainly based on radiographic findings, whereas many patients are more interested in how their body configuration deviates from the normality. There is a need to implement and evaluate a method for this purpose. In brace treated children and adolescents, a non-radiation producing examination is to prefer for repeated follow-up controls.MethodsA consequtive series of children with spine deformity, who are enrolled in the treatment protocol, are invited to take part in the tests. In surgery group, tests are performed before and 3 months after surgery aimed to correct the spine and/or thorax deformity. In brace treatment and follow-up groups tests are made at the same time points as x-rays. The static and dynamic recordings are performed by and optic scanenr Artec 3D (Artec Group, San Diego, CA), and the sitting load distribution measurements with a sensor mat (Clin-seat Type 5315 by Tekscan, Boston, Massachusetts, USA). 60 children/year in brace treatment, 40 in surgery, and 50 in the follow-up group are estimated to be included. These methods´ costs and benefits as well as their added value for the clinical decision making will be evaluated after 2-3 years.ResultsA feasibility test shows that clinically small enough differences can be recorded and numerically expressed and analysed. An application on a consecutive, clinical patient group will be carried on.ConclusionThe optical scanning method by Artec, allows a static and dynamic capturing of respiratoryassociated thorax movements and the changes of a spine deformity over time. The new method will be applied in a consecutive series of patients.
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