Small average differences in attenuation corrected images between men and women in myocardial perfusion scintigraphy: a novel normal stress database

Normal stress perfusion databases were developed with data from 126 male and 205 female patients with normal MPS. The following comparisons were performed for all patients and separately for normal weight vs. obese patients: men vs. women for AC; men vs. women for NC; AC vs. NC for men; and AC vs. NC for women.When comparing AC for men vs. women, only minor differences in mean count values were observed, and there were no differences for normal weight vs. obese patients. For all other analyses major differences were found, particularly for the inferior wall.The results support the hypothesis that it is possible to use not only gender independent but also weight independent AC stress databases.Stress myocardial perfusion scintigraphy (MPS) is widely regarded as a clinically useful noninvasive imaging modality for diagnosing patients with suspected coronary artery disease [1-3]. However, Compton scatter and depth-dependent reduction of spatial resolution degrade MPS image quality and decrease test accuracy. In addition, localized soft-tissue attenuation by the breasts, lateral chest wall, and abdomen may create artefacts that mimic true perfusion abnormalities and decrease test specificity [4,5].Several studies have reported an increase in the diagnostic accuracy (through higher specificity) for the detection of coronary artery disease when MPS is attenuation corrected (AC) [6-12]. The American Society of Nuclear Cardiology and the Society of Nuclear Medicine conclude in their joint position statement from 2004 [6] that incorporation of AC in addition to ECG gating with MPS images will improve image quality, interpretive certainty, and diagnostic accuracy. These combined results are anticipated to have a substantial impact on improving the effectiveness of care and lowering health care costs. However, commonly used software packages for MPS usually only include a normal stress database for non-attenuation corrected (NC) images.The three most commonly used software pac