Evidence map›Paper›PMID 26396025›Full record

ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2017

Sequential SPECT/CT imaging for detection of coronary artery disease in a large cohort: evaluation of the need for additional imaging and radiation exposure.

Elsemiek M Engbers, Jorik R Timmer, Jan Paul Ottervanger, Mohamed Mouden, Ad H J Oostdijk, Siert Knollema, Pieter L Jager

Abstract read
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In one paragraph

Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Value of automatic patient motion detection and correction in myocardial perfusion imaging using a CZT-based SPECT camera.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018
    Article
  3. Myocardial perfusion imaging: Lessons learned and work to be done-update.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018
    Review
  4. Review
  5. Primum non nocere….Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Elsemiek M EngbersDepartment of Cardiology, Isala, Dokter van Heesweg 2, 8025 AB, Zwolle, The Netherlands. elsemiekengbers@gmail.com.
Jorik R TimmerDepartment of Cardiology, Isala, Dokter van Heesweg 2, 8025 AB, Zwolle, The Netherlands. v.r.c.derks@isala.nl.
Jan Paul OttervangerDepartment of Cardiology, Isala, Dokter van Heesweg 2, 8025 AB, Zwolle, The Netherlands.
Mohamed MoudenDepartment of Cardiology, Isala, Dokter van Heesweg 2, 8025 AB, Zwolle, The Netherlands.
Ad H J OostdijkDepartment of Nuclear Medicine, Isala, Dokter van Heesweg 2, 8025 AB, Zwolle, The Netherlands.
Siert KnollemaDepartment of Nuclear Medicine, Isala, Dokter van Heesweg 2, 8025 AB, Zwolle, The Netherlands.
Pieter L JagerDepartment of Nuclear Medicine, Isala, Dokter van Heesweg 2, 8025 AB, Zwolle, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPerforming both single photon emission computerized tomography (SPECT) and coronary computed tomography angiography (CCTA) in patients suspected for coronary artery disease (CAD) leads to increased radiation exposure. We evaluated the need for additional imaging and following implications for radiation exposure of a sequential SPECT/computed tomography (CT) algorithm. METHODS AND

results5018 consecutive patients without history of CAD were referred for stress-first SPECT and coronary artery calcium (CAC) scoring. If stress SPECT was abnormal, additional rest SPECT and, if feasible, CCTA were acquired. Stress SPECT was normal in 2617 patients (52%). CCTA was not performed in 1289 of the 2401 patients referred for additional imaging (54%), mainly because of severe CAC (47%) or fast/irregular heart rate (22%). 642 patients with abnormal SPECT underwent CCTA, which excluded significant CAD in 378 patients (59%). Mean radiation dose was 4.5 ± 0.3 mSv for stress-only imaging and 13.2 ± 3.3 mSv for additional imaging (P < 0.001).

conclusionsHalf of the patients do not require additional imaging in our sequential SPECT/CT algorithm, which is accompanied with low radiation exposure. CCTA cannot be performed in half of the patients who undergo additional imaging because of (relative) contra-indications. CCTA is able to correct for false-positive SPECT findings in our algorithm.

Indexed as

Coronary Artery DiseaseDisease ProgressionFemaleHumansLongitudinal StudiesMaleMedical OveruseMiddle AgedNeeds AssessmentNetherlandsPrevalenceRadiation ExposureReferral and ConsultationRisk FactorsSingle Photon Emission Computed Tomography Computed TomographySubtraction Techniquecoronary artery calcium scorecoronary computed tomography angiographysequential imagingSingle photon emission computed tomographysuspected coronary artery disease

Identifiers

PMID26396025

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.