CT attenuation correction improves quantitative risk prediction by cardiac SPECT in obese patients
Purpose This study aimed to compare the predictive value of CT attenuation-corrected stress total perfusion deficit (AC-sTPD) and non-corrected stress TPD (NC-sTPD) for major adverse cardiac events (MACE) in obese patients undergoing cadmium zinc telluride (CZT) SPECT myocardial perfusion imaging (M...
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| Veröffentlicht in: | European journal of nuclear medicine and molecular imaging 2024-02, Vol.51 (3), p.695-706 |
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| creator | Feher, Attila Pieszko, Konrad Shanbhag, Aakash Lemley, Mark Bednarski, Bryan Miller, Robert J. H. Huang, Cathleen Miras, Leonidas Liu, Yi-Hwa Sinusas, Albert J. Slomka, Piotr J. Miller, Edward J. |
| description | Purpose
This study aimed to compare the predictive value of CT attenuation-corrected stress total perfusion deficit (AC-sTPD) and non-corrected stress TPD (NC-sTPD) for major adverse cardiac events (MACE) in obese patients undergoing cadmium zinc telluride (CZT) SPECT myocardial perfusion imaging (MPI).
Methods
The study included 4,585 patients who underwent CZT SPECT/CT MPI for clinical indications (chest pain: 56%, shortness of breath: 13%, other: 32%) at Yale New Haven Hospital (age: 64 ± 12 years, 45% female, body mass index [BMI]: 30.0 ± 6.3 kg/m
2
, prior coronary artery disease: 18%). The association between AC-sTPD or NC-sTPD and MACE defined as the composite end point of mortality, nonfatal myocardial infarction or late coronary revascularization (> 90 days after SPECT) was evaluated with survival analysis.
Results
During a median follow-up of 25 months, 453 patients (10%) experienced MACE. In patients with BMI ≥ 35 kg/m
2
(
n
= 931), those with AC-sTPD ≥ 3% had worse MACE-free survival than those with AC-sTPD |
| doi_str_mv | 10.1007/s00259-023-06484-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2886328607</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2886328607</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-21ecc3240a960e503e33b8a1b8828cf7a7fa1ee3a1bfe771b328d8b8cf6ebd363</originalsourceid><addsrcrecordid>eNp9kc1OGzEUha2qVUMDL9AFssSGzbTX9uCfJYpCWwmJSoS1ZXvuINNkJtgzKHl7XAZSiUVXvvL9zvGRDyFfGXxjAOp7BuAXpgIuKpC1rqvdB3LEJDOVAm0-HmYFM_Il5wcAprk2n8lMKMNrUcMR8YsVdcOA3eiG2Hc09ClheBnjZpv6J8z0cXTdEIcCPCFNMf-h24RNnCi_p8GlJrpAb38vi1vsaO8xI90WAXZDPiafWrfOePJ6zsnd1XK1-Fld3_z4tbi8roLgcqg4w1CmGpyRgBcgUAivHfO6hA6tcqp1DFGUmxaVYl5w3WhfVhJ9I6SYk_PJt8R-HDEPdhNzwPXaddiP2XKtZdFIUAU9e4c-9GPqSjrLDZO8ZkaYQvGJCqnPOWFrtyluXNpbBvZvA3ZqwJYG7EsDdldEp6_Wo99gc5C8fXkBxATksuruMf17-z-2z8P9ksg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2916241939</pqid></control><display><type>article</type><title>CT attenuation correction improves quantitative risk prediction by cardiac SPECT in obese patients</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Feher, Attila ; Pieszko, Konrad ; Shanbhag, Aakash ; Lemley, Mark ; Bednarski, Bryan ; Miller, Robert J. H. ; Huang, Cathleen ; Miras, Leonidas ; Liu, Yi-Hwa ; Sinusas, Albert J. ; Slomka, Piotr J. ; Miller, Edward J.</creator><creatorcontrib>Feher, Attila ; Pieszko, Konrad ; Shanbhag, Aakash ; Lemley, Mark ; Bednarski, Bryan ; Miller, Robert J. H. ; Huang, Cathleen ; Miras, Leonidas ; Liu, Yi-Hwa ; Sinusas, Albert J. ; Slomka, Piotr J. ; Miller, Edward J.</creatorcontrib><description>Purpose
This study aimed to compare the predictive value of CT attenuation-corrected stress total perfusion deficit (AC-sTPD) and non-corrected stress TPD (NC-sTPD) for major adverse cardiac events (MACE) in obese patients undergoing cadmium zinc telluride (CZT) SPECT myocardial perfusion imaging (MPI).
Methods
The study included 4,585 patients who underwent CZT SPECT/CT MPI for clinical indications (chest pain: 56%, shortness of breath: 13%, other: 32%) at Yale New Haven Hospital (age: 64 ± 12 years, 45% female, body mass index [BMI]: 30.0 ± 6.3 kg/m
2
, prior coronary artery disease: 18%). The association between AC-sTPD or NC-sTPD and MACE defined as the composite end point of mortality, nonfatal myocardial infarction or late coronary revascularization (> 90 days after SPECT) was evaluated with survival analysis.
Results
During a median follow-up of 25 months, 453 patients (10%) experienced MACE. In patients with BMI ≥ 35 kg/m
2
(
n
= 931), those with AC-sTPD ≥ 3% had worse MACE-free survival than those with AC-sTPD < 3% (HR: 2.23, 95% CI: 1.40 – 3.55,
p
= 0.002) with no difference in MACE-free survival between patients with NC-sTPD ≥ 3% and NC-sTPD < 3% (HR:1.06, 95% CI:0.67 – 1.68,
p
= 0.78). AC-sTPD had higher AUC than NC-sTPD for the detection of 2-year MACE in patients with BMI ≥ 35 kg/m
2
(0.631 versus 0.541,
p
= 0.01). In the overall cohort AC-sTPD had a higher ROC area under the curve (AUC, 0.641) than NC-sTPD (0.608;
P
= 0.01) for detection of 2-year MACE. In patients with BMI ≥ 35 kg/m
2
AC sTPD provided significant incremental prognostic value beyond NC sTPD (net reclassification index: 0.14 [95% CI: 0.20 – 0.28]).
Conclusions
AC sTPD outperformed NC sTPD in predicting MACE in patients undergoing SPECT MPI with BMI ≥ 35 kg/m
2
. These findings highlight the superior prognostic value of AC-sTPD in this patient population and underscore the importance of CT attenuation correction.</description><identifier>ISSN: 1619-7070</identifier><identifier>EISSN: 1619-7089</identifier><identifier>DOI: 10.1007/s00259-023-06484-x</identifier><identifier>PMID: 37924340</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Attenuation ; Body mass index ; Body size ; Cadmium ; Cadmium zinc tellurides ; Cardiology ; Cardiovascular disease ; Computed tomography ; Coronary artery disease ; Coronary Artery Disease - complications ; Coronary Artery Disease - diagnostic imaging ; Dyspnea ; Female ; Heart ; Heart diseases ; Humans ; Imaging ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Myocardial Infarction ; Myocardial Perfusion Imaging - methods ; Nuclear Medicine ; Obesity - complications ; Obesity - diagnostic imaging ; Oncology ; Original Article ; Orthopedics ; Patients ; Perfusion ; Prognosis ; Radiology ; Reclassification ; Single photon emission computed tomography ; Survival ; Survival analysis ; Tomography, Emission-Computed, Single-Photon - methods ; Tomography, X-Ray Computed ; Zinc telluride ; Zinc tellurides</subject><ispartof>European journal of nuclear medicine and molecular imaging, 2024-02, Vol.51 (3), p.695-706</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-21ecc3240a960e503e33b8a1b8828cf7a7fa1ee3a1bfe771b328d8b8cf6ebd363</cites><orcidid>0000-0002-2561-4282</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00259-023-06484-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00259-023-06484-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37924340$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Feher, Attila</creatorcontrib><creatorcontrib>Pieszko, Konrad</creatorcontrib><creatorcontrib>Shanbhag, Aakash</creatorcontrib><creatorcontrib>Lemley, Mark</creatorcontrib><creatorcontrib>Bednarski, Bryan</creatorcontrib><creatorcontrib>Miller, Robert J. H.</creatorcontrib><creatorcontrib>Huang, Cathleen</creatorcontrib><creatorcontrib>Miras, Leonidas</creatorcontrib><creatorcontrib>Liu, Yi-Hwa</creatorcontrib><creatorcontrib>Sinusas, Albert J.</creatorcontrib><creatorcontrib>Slomka, Piotr J.</creatorcontrib><creatorcontrib>Miller, Edward J.</creatorcontrib><title>CT attenuation correction improves quantitative risk prediction by cardiac SPECT in obese patients</title><title>European journal of nuclear medicine and molecular imaging</title><addtitle>Eur J Nucl Med Mol Imaging</addtitle><addtitle>Eur J Nucl Med Mol Imaging</addtitle><description>Purpose
This study aimed to compare the predictive value of CT attenuation-corrected stress total perfusion deficit (AC-sTPD) and non-corrected stress TPD (NC-sTPD) for major adverse cardiac events (MACE) in obese patients undergoing cadmium zinc telluride (CZT) SPECT myocardial perfusion imaging (MPI).
Methods
The study included 4,585 patients who underwent CZT SPECT/CT MPI for clinical indications (chest pain: 56%, shortness of breath: 13%, other: 32%) at Yale New Haven Hospital (age: 64 ± 12 years, 45% female, body mass index [BMI]: 30.0 ± 6.3 kg/m
2
, prior coronary artery disease: 18%). The association between AC-sTPD or NC-sTPD and MACE defined as the composite end point of mortality, nonfatal myocardial infarction or late coronary revascularization (> 90 days after SPECT) was evaluated with survival analysis.
Results
During a median follow-up of 25 months, 453 patients (10%) experienced MACE. In patients with BMI ≥ 35 kg/m
2
(
n
= 931), those with AC-sTPD ≥ 3% had worse MACE-free survival than those with AC-sTPD < 3% (HR: 2.23, 95% CI: 1.40 – 3.55,
p
= 0.002) with no difference in MACE-free survival between patients with NC-sTPD ≥ 3% and NC-sTPD < 3% (HR:1.06, 95% CI:0.67 – 1.68,
p
= 0.78). AC-sTPD had higher AUC than NC-sTPD for the detection of 2-year MACE in patients with BMI ≥ 35 kg/m
2
(0.631 versus 0.541,
p
= 0.01). In the overall cohort AC-sTPD had a higher ROC area under the curve (AUC, 0.641) than NC-sTPD (0.608;
P
= 0.01) for detection of 2-year MACE. In patients with BMI ≥ 35 kg/m
2
AC sTPD provided significant incremental prognostic value beyond NC sTPD (net reclassification index: 0.14 [95% CI: 0.20 – 0.28]).
Conclusions
AC sTPD outperformed NC sTPD in predicting MACE in patients undergoing SPECT MPI with BMI ≥ 35 kg/m
2
. These findings highlight the superior prognostic value of AC-sTPD in this patient population and underscore the importance of CT attenuation correction.</description><subject>Aged</subject><subject>Attenuation</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Cadmium</subject><subject>Cadmium zinc tellurides</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Computed tomography</subject><subject>Coronary artery disease</subject><subject>Coronary Artery Disease - complications</subject><subject>Coronary Artery Disease - diagnostic imaging</subject><subject>Dyspnea</subject><subject>Female</subject><subject>Heart</subject><subject>Heart diseases</subject><subject>Humans</subject><subject>Imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Myocardial Infarction</subject><subject>Myocardial Perfusion Imaging - methods</subject><subject>Nuclear Medicine</subject><subject>Obesity - complications</subject><subject>Obesity - diagnostic imaging</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Patients</subject><subject>Perfusion</subject><subject>Prognosis</subject><subject>Radiology</subject><subject>Reclassification</subject><subject>Single photon emission computed tomography</subject><subject>Survival</subject><subject>Survival analysis</subject><subject>Tomography, Emission-Computed, Single-Photon - methods</subject><subject>Tomography, X-Ray Computed</subject><subject>Zinc telluride</subject><subject>Zinc tellurides</subject><issn>1619-7070</issn><issn>1619-7089</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1OGzEUha2qVUMDL9AFssSGzbTX9uCfJYpCWwmJSoS1ZXvuINNkJtgzKHl7XAZSiUVXvvL9zvGRDyFfGXxjAOp7BuAXpgIuKpC1rqvdB3LEJDOVAm0-HmYFM_Il5wcAprk2n8lMKMNrUcMR8YsVdcOA3eiG2Hc09ClheBnjZpv6J8z0cXTdEIcCPCFNMf-h24RNnCi_p8GlJrpAb38vi1vsaO8xI90WAXZDPiafWrfOePJ6zsnd1XK1-Fld3_z4tbi8roLgcqg4w1CmGpyRgBcgUAivHfO6hA6tcqp1DFGUmxaVYl5w3WhfVhJ9I6SYk_PJt8R-HDEPdhNzwPXaddiP2XKtZdFIUAU9e4c-9GPqSjrLDZO8ZkaYQvGJCqnPOWFrtyluXNpbBvZvA3ZqwJYG7EsDdldEp6_Wo99gc5C8fXkBxATksuruMf17-z-2z8P9ksg</recordid><startdate>20240201</startdate><enddate>20240201</enddate><creator>Feher, Attila</creator><creator>Pieszko, Konrad</creator><creator>Shanbhag, Aakash</creator><creator>Lemley, Mark</creator><creator>Bednarski, Bryan</creator><creator>Miller, Robert J. H.</creator><creator>Huang, Cathleen</creator><creator>Miras, Leonidas</creator><creator>Liu, Yi-Hwa</creator><creator>Sinusas, Albert J.</creator><creator>Slomka, Piotr J.</creator><creator>Miller, Edward J.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2561-4282</orcidid></search><sort><creationdate>20240201</creationdate><title>CT attenuation correction improves quantitative risk prediction by cardiac SPECT in obese patients</title><author>Feher, Attila ; Pieszko, Konrad ; Shanbhag, Aakash ; Lemley, Mark ; Bednarski, Bryan ; Miller, Robert J. H. ; Huang, Cathleen ; Miras, Leonidas ; Liu, Yi-Hwa ; Sinusas, Albert J. ; Slomka, Piotr J. ; Miller, Edward J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-21ecc3240a960e503e33b8a1b8828cf7a7fa1ee3a1bfe771b328d8b8cf6ebd363</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Attenuation</topic><topic>Body mass index</topic><topic>Body size</topic><topic>Cadmium</topic><topic>Cadmium zinc tellurides</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Computed tomography</topic><topic>Coronary artery disease</topic><topic>Coronary Artery Disease - complications</topic><topic>Coronary Artery Disease - diagnostic imaging</topic><topic>Dyspnea</topic><topic>Female</topic><topic>Heart</topic><topic>Heart diseases</topic><topic>Humans</topic><topic>Imaging</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Myocardial Infarction</topic><topic>Myocardial Perfusion Imaging - methods</topic><topic>Nuclear Medicine</topic><topic>Obesity - complications</topic><topic>Obesity - diagnostic imaging</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Patients</topic><topic>Perfusion</topic><topic>Prognosis</topic><topic>Radiology</topic><topic>Reclassification</topic><topic>Single photon emission computed tomography</topic><topic>Survival</topic><topic>Survival analysis</topic><topic>Tomography, Emission-Computed, Single-Photon - methods</topic><topic>Tomography, X-Ray Computed</topic><topic>Zinc telluride</topic><topic>Zinc tellurides</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Feher, Attila</creatorcontrib><creatorcontrib>Pieszko, Konrad</creatorcontrib><creatorcontrib>Shanbhag, Aakash</creatorcontrib><creatorcontrib>Lemley, Mark</creatorcontrib><creatorcontrib>Bednarski, Bryan</creatorcontrib><creatorcontrib>Miller, Robert J. H.</creatorcontrib><creatorcontrib>Huang, Cathleen</creatorcontrib><creatorcontrib>Miras, Leonidas</creatorcontrib><creatorcontrib>Liu, Yi-Hwa</creatorcontrib><creatorcontrib>Sinusas, Albert J.</creatorcontrib><creatorcontrib>Slomka, Piotr J.</creatorcontrib><creatorcontrib>Miller, Edward J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of nuclear medicine and molecular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Feher, Attila</au><au>Pieszko, Konrad</au><au>Shanbhag, Aakash</au><au>Lemley, Mark</au><au>Bednarski, Bryan</au><au>Miller, Robert J. H.</au><au>Huang, Cathleen</au><au>Miras, Leonidas</au><au>Liu, Yi-Hwa</au><au>Sinusas, Albert J.</au><au>Slomka, Piotr J.</au><au>Miller, Edward J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>CT attenuation correction improves quantitative risk prediction by cardiac SPECT in obese patients</atitle><jtitle>European journal of nuclear medicine and molecular imaging</jtitle><stitle>Eur J Nucl Med Mol Imaging</stitle><addtitle>Eur J Nucl Med Mol Imaging</addtitle><date>2024-02-01</date><risdate>2024</risdate><volume>51</volume><issue>3</issue><spage>695</spage><epage>706</epage><pages>695-706</pages><issn>1619-7070</issn><eissn>1619-7089</eissn><abstract>Purpose
This study aimed to compare the predictive value of CT attenuation-corrected stress total perfusion deficit (AC-sTPD) and non-corrected stress TPD (NC-sTPD) for major adverse cardiac events (MACE) in obese patients undergoing cadmium zinc telluride (CZT) SPECT myocardial perfusion imaging (MPI).
Methods
The study included 4,585 patients who underwent CZT SPECT/CT MPI for clinical indications (chest pain: 56%, shortness of breath: 13%, other: 32%) at Yale New Haven Hospital (age: 64 ± 12 years, 45% female, body mass index [BMI]: 30.0 ± 6.3 kg/m
2
, prior coronary artery disease: 18%). The association between AC-sTPD or NC-sTPD and MACE defined as the composite end point of mortality, nonfatal myocardial infarction or late coronary revascularization (> 90 days after SPECT) was evaluated with survival analysis.
Results
During a median follow-up of 25 months, 453 patients (10%) experienced MACE. In patients with BMI ≥ 35 kg/m
2
(
n
= 931), those with AC-sTPD ≥ 3% had worse MACE-free survival than those with AC-sTPD < 3% (HR: 2.23, 95% CI: 1.40 – 3.55,
p
= 0.002) with no difference in MACE-free survival between patients with NC-sTPD ≥ 3% and NC-sTPD < 3% (HR:1.06, 95% CI:0.67 – 1.68,
p
= 0.78). AC-sTPD had higher AUC than NC-sTPD for the detection of 2-year MACE in patients with BMI ≥ 35 kg/m
2
(0.631 versus 0.541,
p
= 0.01). In the overall cohort AC-sTPD had a higher ROC area under the curve (AUC, 0.641) than NC-sTPD (0.608;
P
= 0.01) for detection of 2-year MACE. In patients with BMI ≥ 35 kg/m
2
AC sTPD provided significant incremental prognostic value beyond NC sTPD (net reclassification index: 0.14 [95% CI: 0.20 – 0.28]).
Conclusions
AC sTPD outperformed NC sTPD in predicting MACE in patients undergoing SPECT MPI with BMI ≥ 35 kg/m
2
. These findings highlight the superior prognostic value of AC-sTPD in this patient population and underscore the importance of CT attenuation correction.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>37924340</pmid><doi>10.1007/s00259-023-06484-x</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-2561-4282</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | European journal of nuclear medicine and molecular imaging, 2024-02, Vol.51 (3), p.695-706 |
| issn | 1619-7070 1619-7089 |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Aged Attenuation Body mass index Body size Cadmium Cadmium zinc tellurides Cardiology Cardiovascular disease Computed tomography Coronary artery disease Coronary Artery Disease - complications Coronary Artery Disease - diagnostic imaging Dyspnea Female Heart Heart diseases Humans Imaging Male Medicine Medicine & Public Health Middle Aged Myocardial Infarction Myocardial Perfusion Imaging - methods Nuclear Medicine Obesity - complications Obesity - diagnostic imaging Oncology Original Article Orthopedics Patients Perfusion Prognosis Radiology Reclassification Single photon emission computed tomography Survival Survival analysis Tomography, Emission-Computed, Single-Photon - methods Tomography, X-Ray Computed Zinc telluride Zinc tellurides |
| title | CT attenuation correction improves quantitative risk prediction by cardiac SPECT in obese patients |
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