CLINICAL USE OF CARDIAC SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY (SPECT)
Salma Hesham Alsayed;
Abstract
Throughout the period from 1993 to 2001, there has been an explosive growth in cardiovascular imaging with stress testing.
In response to these developments, the American College of Cardiology pioneered appropriateness criteria for single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in 2005.
The criteria were developed to account for evidence-based clinical relevance of stress perfusion imaging and were the first cardiology specific document to address appropriateness. The criteria relied on the modified RAND/UCLA methodology to identify 52 common clinical scenarios that were divided by level of appropriateness into appropriate, uncertain, and inappropriate indications.
Aim of or study was to evaluate appropriateness use criteria and the downstream use of resources as defined by patient outcomes in different nuclear centers.
The study included 442 patients undergoing SPECT in Kobry al Kobba military hospital and Ain Shams University hospitals throughout the period from February 2012 to august 2012.
All patients were subjected to thorough history taking, calculation of pretest probability and Framingham risk score, determination of appropriateness use criteria and stress-rest Tc 99m imaging to detect the presence of ischemia and one day Tc 99m imaging to detect viability.
The study included 442 patients with mean age of 56.5 years, with male predominance (77%), 38% were diabetics and 58% had hypertension.
78% of patients had appropriate tests, uncertain tests in 12% and 10% inappropriate studies. 47% of appropriate tests show positive results of SPECT.
This study demonstrates the application of appropriateness criteria to attempt quality improvement in the clinical use of stress cardiac imaging.
We concluded that appropriateness criteria are effective in identifying appropriateness of SPECT in a diverse patient population.
We recommend another long term study that include larger number of patients.
In response to these developments, the American College of Cardiology pioneered appropriateness criteria for single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in 2005.
The criteria were developed to account for evidence-based clinical relevance of stress perfusion imaging and were the first cardiology specific document to address appropriateness. The criteria relied on the modified RAND/UCLA methodology to identify 52 common clinical scenarios that were divided by level of appropriateness into appropriate, uncertain, and inappropriate indications.
Aim of or study was to evaluate appropriateness use criteria and the downstream use of resources as defined by patient outcomes in different nuclear centers.
The study included 442 patients undergoing SPECT in Kobry al Kobba military hospital and Ain Shams University hospitals throughout the period from February 2012 to august 2012.
All patients were subjected to thorough history taking, calculation of pretest probability and Framingham risk score, determination of appropriateness use criteria and stress-rest Tc 99m imaging to detect the presence of ischemia and one day Tc 99m imaging to detect viability.
The study included 442 patients with mean age of 56.5 years, with male predominance (77%), 38% were diabetics and 58% had hypertension.
78% of patients had appropriate tests, uncertain tests in 12% and 10% inappropriate studies. 47% of appropriate tests show positive results of SPECT.
This study demonstrates the application of appropriateness criteria to attempt quality improvement in the clinical use of stress cardiac imaging.
We concluded that appropriateness criteria are effective in identifying appropriateness of SPECT in a diverse patient population.
We recommend another long term study that include larger number of patients.
Other data
| Title | CLINICAL USE OF CARDIAC SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY (SPECT) | Other Titles | الاستخدام الاكلينيكي للمسح الذرى للقلب | Authors | Salma Hesham Alsayed | Issue Date | 2014 |
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