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Myocardial perfusion scintigraphy prior to kidney transplant: the role of attenuation correction with computed tomography
Session:
Painel 3 - Imagiologia Cardiovascular 5
Speaker:
Mauro Monteiro
Congress:
CPC 2020
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.4 Nuclear Imaging
Session Type:
Posters
FP Number:
---
Authors:
Mauro Monteiro; João Gameiro; Rodolfo Silva; Tiago Saraiva; Maria João Ferreira; Maria João Cunha; Gracinda Costa; João Pedroso de Lima
Abstract
<p><strong>Introduction</strong></p> <p>Attenuation artifacts in myocardial perfusion scintigraphy (MPS) caused by subdiaphragmatic structures, breast and fat tissue reduce the specificity of the test. Several technics to overcome this limitation were developed, such as attenuation correction (AC). Kidney transplant candidates have higher perioperative risk due to the higher probability of myocardial ischemia (MI). Therefore, screening for MI before transplant is a common procedure and MPS is frequently used. The purpose of this study is to assess the role of AC with computed tomography (CT) on MPS performed on renal transplant candidates.</p> <p> </p> <p><strong>Methods</strong></p> <p>A cohort of 3332 patients that underwent MPS between January 2016 and December 2018 was retrospectively reviewed. All kidney transplant candidates that performed MPS with and without AC an had a final report considered normal were selected. Perfusion defects were quantified using a 17-segment model and the Summed Stress Score (SSS) was calculated, on both with and without AC studies. Defects were grouped according to the coronary artery territories: left anterior descending (LAD), except the apex segment; circumflex (Cx); right coronary (RC). All relevant data, including demographic variables, was recorded and statistical analysis was performed using SPSS version 25.0.</p> <p> </p> <p><strong>Results</strong></p> <p>A total of 155 patients were selected (male gender n = 119 (76.7%); mean age 61,0±8,1, 35-76 years old). Statistically significant difference on SSS was found between studies with and without AC (AC = 0,65% vs without AC = 3,29%, p<0.000). When comparing each coronary artery territory, statistically significant differences were found on the segments assigned to LDA (AC = 0,08% vs without AC = 0,99%, p<0.000), Cx (AC = 0,13% vs without AC = 1,52%, p<0.000), RC (AC = 0,13% vs without AC = 7,97%, p<0.000) and apex (AC = 9,68% vs without AC = 2,6%, p<0.000).</p> <p> </p> <p><strong>Conclusion</strong></p> <p>Attenuation correction with CT has a significant impact on the results of MPS. In this group of patients the use of attenuation correction leads to a higher number of normal results avoiding probably unnecessary invasive evaluations.</p>
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