Comparison of the diagnostic accuracies of very low stress-dose with standard-dose myocardial perfusion imaging: Automated quantification of one-day, stress-first SPECT using a CZT camera

Previous studies have demonstrated accurate diagnosis of reduced dose myocardial perfusion imaging (mpi) using cadmium-zinc-telluride (czt) technology. we compared the diagnostic performances of very low stress-dose (<2 msv) with standard-dose stress-first, quantitative mpi using a czt camera. patients without known coronary artery– disease who underwent a stress-first tc-99 m sestamibi czt-mpi and invasive coronary angiography (ica), and low-risk patients without ica were included. a stress-rest standard-dose (10/30 mci) mpi and a low-dose (5/15 mci) mpi were compared. normal limits for quantification were developed from 40 (20 males) low-risk patients, and total perfusion deficit (tpd) was derived. 208 patients who underwent mpi and ica, and 76 low-risk patients were included. of these, 128 had a standard-dose mpi and 156 had a low-dose mpi. stress-doses in low-dose and standard-dose groups were 5.9 ± 1.2 vs 10.2 ± 0.5 mci (1.7 ± 0.3 vs 3.0 ± 0.1 msv), respectively, p < 0.001, and stress-rest effective radiation was 6.9 ± 1.1 vs 11.7 ± 0.4 msv, respectively, p < 0.001. sensitivity, specificity, and accuracy values in the low-dose and standard-dose groups were 86.1%, 76.6%, and 81.4%; and 90.6%, 78.1%, and 84.4%, respectively, p = ns. using tpd prone, specificity values were 84.9% and 80.3%, respectively, p = ns. one-day stress-first mpi with 50% radiation reduction and a very low stress-dose (<2 msv) using czt technology and quantitative supine and prone analysis provided a high diagnostic value, similar to standard-dose mpi.