Accuracy of cadmium-zinc-telluride imaging in detecting single and multivessel coronary artery disease: Is there any gender difference?

Abstract

Purpose: To evaluate gender-related differences in diagnostic accuracy of cadmium‑zinc-telluride (CZT) myocardial perfusion imaging in detecting single- and multi-vessel coronary artery disease (CAD).

Methods: We prospectively enrolled 1161 consecutive patients with known or suspected coronary artery disease (288, 25% women and 873, 75% men) who had been referred to our laboratory for stress-rest myocardial perfusion imaging (single-day stress-rest protocol, mean radiation dose: 4 mSv). All patients underwent coronary angiography within 30 days; significant CAD was defined in the presence of a coronary stenosis >70%. Summed stress scores (SSS), summed rest scores (SRS) and summed difference scores (SDS) were obtained. Image quality was graded "good" or better in >90% of patients.

Results: On coronary angiography, left main trunk, left anterior descending artery, left circumflex artery and right coronary artery obstructive stenosis were seen in 13, 486, 393 and 499 patients, respectively. Global SSS was the best predictor of CAD in women (AUC = 0.866, 81% sensitivity and 79% specificity) and in men (AUC = 0.871, 76% sensitivity and 84% specificity). Interestingly, its accuracy was maintained also in patients with two-vessel (women: AUC = 0.842, p < 0.001; men: AUC 0.839, p < 0.001) or three-vessel disease (women: AUC = 0.800, p < 0.001; men: AUC 0.804, p < 0.001). There was no gender-related difference in terms of diagnostic accuracy.

Conclusions: Evaluation of multivessel disease can be obtained by CZT camera in men as well as in women, with high accuracy at a lower radiation exposure.

Keywords: Cadmium‑zinc-telluride; Coronary artery disease; Multi-vessel disease; Myocardial perfusion imaging; Women.