Determination of the quantitative thallium imaging variables that optimize detection of coronary artery disease

Sanjiv Kaul, C. A. Boucher, J. B. Newell, D. A. Chesler, J. M. Greenberg, R. D. Okada, H. W. Strauss, R. E. Dinsmore, G. M. Pohost

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Although quantification of exercise thallium images has been previously reported, the relative value of different imaging variables for detection of coronary artery disease has not been analyzed in a large group of patients with cardiac catheterization data. Regional initial thallium uptake, redistribution and clearance on thallium study were measured in 325 patients also undergoing cardiac catheterization (281 patients with and 44 patients without coronary artery disease). Normal values were defined in 55 other clinically normal subjects. When five myocardial segments were analyzed in each view, the respective values for sensitivity and specificity were 95 and 50% for initial thallium uptake, 60 and 87% for redistribution and 74 and 66% for clearance. Initial thallium uptake was the most sensitive but least specific (p <0.001), whereas redistribution was the least sensitive and most specific (p <0.001). Using stepwise logistic regression analysis, the best correlate of coronary artery disease was initial thallium uptake. Addition of redistribution to a mathematical model of the probability of coronary artery disease did not alter sensitivity, but increased specificity from 50 to 70% (p <0.001). Once initial uptake and redistribution were considered, myocardial thallium clearance provided no additional improvement in the correlation. Excluding the two basal segments in each view from the analysis increased the specificity from 70 to 80% (p <0.001) without affecting sensitivity. Of the 15 patients (5%) with coronary disease not detected using this approach, none had left main disease and 10 (67%) had one vessel disease. A combination of variables derived from quantification of exercise thallium images provides a superior sensitivity and specificity for the detection of coronary artery disease compared with the use of a single variable.

Original languageEnglish (US)
Pages (from-to)527-537
Number of pages11
JournalJournal of the American College of Cardiology
Volume7
Issue number3
StatePublished - 1986
Externally publishedYes

Fingerprint

Thallium
Coronary Artery Disease
Cardiac Catheterization
Sensitivity and Specificity
Exercise
Coronary Disease
Reference Values
Theoretical Models
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Kaul, S., Boucher, C. A., Newell, J. B., Chesler, D. A., Greenberg, J. M., Okada, R. D., ... Pohost, G. M. (1986). Determination of the quantitative thallium imaging variables that optimize detection of coronary artery disease. Journal of the American College of Cardiology, 7(3), 527-537.

Determination of the quantitative thallium imaging variables that optimize detection of coronary artery disease. / Kaul, Sanjiv; Boucher, C. A.; Newell, J. B.; Chesler, D. A.; Greenberg, J. M.; Okada, R. D.; Strauss, H. W.; Dinsmore, R. E.; Pohost, G. M.

In: Journal of the American College of Cardiology, Vol. 7, No. 3, 1986, p. 527-537.

Research output: Contribution to journalArticle

Kaul, S, Boucher, CA, Newell, JB, Chesler, DA, Greenberg, JM, Okada, RD, Strauss, HW, Dinsmore, RE & Pohost, GM 1986, 'Determination of the quantitative thallium imaging variables that optimize detection of coronary artery disease', Journal of the American College of Cardiology, vol. 7, no. 3, pp. 527-537.
Kaul, Sanjiv ; Boucher, C. A. ; Newell, J. B. ; Chesler, D. A. ; Greenberg, J. M. ; Okada, R. D. ; Strauss, H. W. ; Dinsmore, R. E. ; Pohost, G. M. / Determination of the quantitative thallium imaging variables that optimize detection of coronary artery disease. In: Journal of the American College of Cardiology. 1986 ; Vol. 7, No. 3. pp. 527-537.
@article{63446452a12948e9a316c49616ca9ef1,
title = "Determination of the quantitative thallium imaging variables that optimize detection of coronary artery disease",
abstract = "Although quantification of exercise thallium images has been previously reported, the relative value of different imaging variables for detection of coronary artery disease has not been analyzed in a large group of patients with cardiac catheterization data. Regional initial thallium uptake, redistribution and clearance on thallium study were measured in 325 patients also undergoing cardiac catheterization (281 patients with and 44 patients without coronary artery disease). Normal values were defined in 55 other clinically normal subjects. When five myocardial segments were analyzed in each view, the respective values for sensitivity and specificity were 95 and 50{\%} for initial thallium uptake, 60 and 87{\%} for redistribution and 74 and 66{\%} for clearance. Initial thallium uptake was the most sensitive but least specific (p <0.001), whereas redistribution was the least sensitive and most specific (p <0.001). Using stepwise logistic regression analysis, the best correlate of coronary artery disease was initial thallium uptake. Addition of redistribution to a mathematical model of the probability of coronary artery disease did not alter sensitivity, but increased specificity from 50 to 70{\%} (p <0.001). Once initial uptake and redistribution were considered, myocardial thallium clearance provided no additional improvement in the correlation. Excluding the two basal segments in each view from the analysis increased the specificity from 70 to 80{\%} (p <0.001) without affecting sensitivity. Of the 15 patients (5{\%}) with coronary disease not detected using this approach, none had left main disease and 10 (67{\%}) had one vessel disease. A combination of variables derived from quantification of exercise thallium images provides a superior sensitivity and specificity for the detection of coronary artery disease compared with the use of a single variable.",
author = "Sanjiv Kaul and Boucher, {C. A.} and Newell, {J. B.} and Chesler, {D. A.} and Greenberg, {J. M.} and Okada, {R. D.} and Strauss, {H. W.} and Dinsmore, {R. E.} and Pohost, {G. M.}",
year = "1986",
language = "English (US)",
volume = "7",
pages = "527--537",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "3",

}

TY - JOUR

T1 - Determination of the quantitative thallium imaging variables that optimize detection of coronary artery disease

AU - Kaul, Sanjiv

AU - Boucher, C. A.

AU - Newell, J. B.

AU - Chesler, D. A.

AU - Greenberg, J. M.

AU - Okada, R. D.

AU - Strauss, H. W.

AU - Dinsmore, R. E.

AU - Pohost, G. M.

PY - 1986

Y1 - 1986

N2 - Although quantification of exercise thallium images has been previously reported, the relative value of different imaging variables for detection of coronary artery disease has not been analyzed in a large group of patients with cardiac catheterization data. Regional initial thallium uptake, redistribution and clearance on thallium study were measured in 325 patients also undergoing cardiac catheterization (281 patients with and 44 patients without coronary artery disease). Normal values were defined in 55 other clinically normal subjects. When five myocardial segments were analyzed in each view, the respective values for sensitivity and specificity were 95 and 50% for initial thallium uptake, 60 and 87% for redistribution and 74 and 66% for clearance. Initial thallium uptake was the most sensitive but least specific (p <0.001), whereas redistribution was the least sensitive and most specific (p <0.001). Using stepwise logistic regression analysis, the best correlate of coronary artery disease was initial thallium uptake. Addition of redistribution to a mathematical model of the probability of coronary artery disease did not alter sensitivity, but increased specificity from 50 to 70% (p <0.001). Once initial uptake and redistribution were considered, myocardial thallium clearance provided no additional improvement in the correlation. Excluding the two basal segments in each view from the analysis increased the specificity from 70 to 80% (p <0.001) without affecting sensitivity. Of the 15 patients (5%) with coronary disease not detected using this approach, none had left main disease and 10 (67%) had one vessel disease. A combination of variables derived from quantification of exercise thallium images provides a superior sensitivity and specificity for the detection of coronary artery disease compared with the use of a single variable.

AB - Although quantification of exercise thallium images has been previously reported, the relative value of different imaging variables for detection of coronary artery disease has not been analyzed in a large group of patients with cardiac catheterization data. Regional initial thallium uptake, redistribution and clearance on thallium study were measured in 325 patients also undergoing cardiac catheterization (281 patients with and 44 patients without coronary artery disease). Normal values were defined in 55 other clinically normal subjects. When five myocardial segments were analyzed in each view, the respective values for sensitivity and specificity were 95 and 50% for initial thallium uptake, 60 and 87% for redistribution and 74 and 66% for clearance. Initial thallium uptake was the most sensitive but least specific (p <0.001), whereas redistribution was the least sensitive and most specific (p <0.001). Using stepwise logistic regression analysis, the best correlate of coronary artery disease was initial thallium uptake. Addition of redistribution to a mathematical model of the probability of coronary artery disease did not alter sensitivity, but increased specificity from 50 to 70% (p <0.001). Once initial uptake and redistribution were considered, myocardial thallium clearance provided no additional improvement in the correlation. Excluding the two basal segments in each view from the analysis increased the specificity from 70 to 80% (p <0.001) without affecting sensitivity. Of the 15 patients (5%) with coronary disease not detected using this approach, none had left main disease and 10 (67%) had one vessel disease. A combination of variables derived from quantification of exercise thallium images provides a superior sensitivity and specificity for the detection of coronary artery disease compared with the use of a single variable.

UR - http://www.scopus.com/inward/record.url?scp=0022650073&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0022650073&partnerID=8YFLogxK

M3 - Article

VL - 7

SP - 527

EP - 537

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 3

ER -