Comparison of gated sestamibi myocardial perfusion imaging between upright solid state and standard supine gamma systems.

Abstract Background: There are no data directly comparing myocardial perfusion imaging (MPI) with upright solid state and standard supine gamma for imaging characteristics and clinical interpretation. Methods: A series of 54 patients underwent clinically indicated upright solid state and standard supine gamma MPI, respectively, in a randomized fashion. Image acquisition time, for both systems, was 25 seconds/projection at rest and 30 seconds/ projection at stress, for 64 projections. Images were interpreted for the presence or absence of coronary artery disease (CAD) and ventricular function by a consensus of 3 expert readers blinded to patient identifiers. Results: There was moderate agreement for the detection of coronary artery disease. Perfusion Supine normal Supine CAD Agreement = 78% Kappa = 0.486 Total = 54 Upright Normal 31 5 Upright CAD 7 11 Among patients identified as having CAD by both systems (n=11), upright solid state imaging resulted in higher summed stress scores [12.3 ± 8.7 versus 18.1 ±11.7 (p Function Supine > 50% Supine Agreement = 94% Kappa = 0.804 Total = 49 Upright >50% 38 1 Upright 2 8 Conclusion: Upright solid state imaging is equivalent to supine standard gamma MPI for the diagnosis of CAD utilizing myocardial perfusion and function.