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Appropriate use criteria (AUC) for Single-Photon Emission Computed Tomography Myocardial Perfusion Images (SPECT) were developed to address growth of cardiac imaging studies. However, these criteria have not been vigorously validated. We sought to determine the rate of abnormal stress SPECT and subsequent revascularization procedures as categorized by AUC.
We retrospectively examined 280 patients who underwent stress SPECT and categorized these studies as appropriate, inappropriate, or uncertain based on AUC. Data regarding subsequent angiography and revascularization within 6 months after SPECT were collected from the electronic medical record.
280 patients met the inclusion criteria (age 67.3±11.4 y, 64% male). When categorized by AUC, 63% (n=176) of SPECT were appropriate, 14% (n=38) uncertain, and 23% (n=66) inappropriate. Compared to inappropriate and uncertain SPECT studies, appropriate studies were more likely to have intermediate or high risk summed stress score results (P=0.008), had an increased rate of subsequent coronary angiography (P=0.003) as well as an increased rate of subsequent revascularization (P=0.006). Attached figure summarizes these findings.
Appropriate stress SPECT are more likely to result in abnormal results requiring subsequent revascularization compared to inappropriate and uncertain studies. Inappropriate and uncertain stress SPECT did not lead to subsequent revascularization.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: SPECT: Appropriate Use Criteria and Role in Specific Populations
Abstract Category: 21. Imaging: Nuclear
Presentation Number: 1229-359
- 2013 American College of Cardiology Foundation