Three-dimensional color-modulated display of myocardial SPECT perfusion distributions accurately assesses coronary artery disease.

Abstract

The objective of this study was to compare visual assessment of 3-dimensional color-modulated (to counts) surface displays with visual assessment of oblique tomographic slices of myocardial SPECT perfusion distributions in the detection and localization of coronary artery disease (CAD). Sixty-two consecutive patients (41 men, 21 women; mean age, 61 +/- 11 y) who had undergone conventional dual-isotope perfusion SPECT were retrospectively chosen; 50 had undergone coronary arteriography previously, and 12 had less than a 5% likelihood of CAD. Four readers interpreted the 3-dimensional displays and slices in separate sessions while unaware of the findings of previous readings, the interpretations of others, and the angiographic results. The readers used a 5-point scoring system. Their average score was used for receiver operating characteristic (ROC) analysis. The area under the ROC curves was determined so that the ability of the 2 methods to detect and localize CAD could be compared. No significant differences were found between visual interpretation of 3-dimensional displays and visual interpretation of slices. These preliminary results indicate that visual interpretation of 3-dimensional displays of myocardial perfusion SPECT distributions may someday replace visual assessment of conventional slices without loss of diagnostic accuracy.