Comparison between dobutamine echocardiography and single-photon emission computed tomography for interpretive...

Area of Science:

• Cardiology
• Medical Imaging
• Diagnostic Techniques

Background:

• Interpretive variability exists for dobutamine stress echocardiography (DSE) and stress single-photon emission computed tomography (SPECT).
• Direct comparative studies on the interpretive reproducibility of DSE and SPECT within the same patient cohort are limited.

Purpose of the Study:

• To directly compare the interpretive reproducibility of DSE and stress SPECT.
• To evaluate both intra- and interobserver agreement for these diagnostic modalities.

Main Methods:

• Simultaneous DSE and SPECT were performed in 56 patients early after acute myocardial infarction.
• Intra- and interobserver concordances were assessed using exact agreement and kappa statistics.
• Intraclass coefficients of correlation were used for segmental score analysis reproducibility.

Main Results:

• Intraobserver agreement for ischemia identification was 98% for SPECT and 91% for DSE (p=NS).
• Interobserver agreement was significantly higher for SPECT (96%) than for DSE (79%; p < 0.01).
• SPECT showed higher intra- and interobserver reproducibility coefficients (0.98, 0.97) compared to DSE (0.80, 0.71; p < 0.001).

Conclusions:

• Stress SPECT imaging exhibits superior interpretive reproducibility compared to DSE in patients following uncomplicated acute myocardial infarction.
• These findings suggest SPECT may be a more reliable imaging modality for assessing myocardial ischemia in this patient population.
• The improved reproducibility of SPECT could lead to more consistent clinical decision-making.