Specificity of Myocardial Perfusion Imaging: Issues With Proposed MBS Item Review

Heart Lung Circ. 2019 Mar;28(3):e23-e25. doi: 10.1016/j.hlc.2018.04.304. Epub 2018 May 27.

Abstract

Myocardial perfusion scanning (MPS) is commonly used to assess patients with an intermediate to high risk of coronary artery disease. Concerns have been raised about the accuracy of this test. There is little recent data regarding the specificity of the MPS in the context of current medical therapy. The primary objective of this study is to determine the specificity of MPS in diagnosing obstructive coronary artery disease. A total of 184 patients fulfilled study criteria. The overall specificity of MPS for obstructive coronary artery disease was 54%.The only demographic variable that influenced specificity was gender: males with a specificity of 66% and females with a specificity of 29% (p-value=0.001). These results suggest that the real world specificity of MPS is lower than previously indicated, particularly in the female population. The limitations proposed by the Cardiac Services Committee Report are therefore unlikely to improve patient outcomes.

Keywords: Coronary angiography; Myocardial perfusion scintigraphy; Non-invasive assessment; Specificity.

MeSH terms

  • Aged
  • Coronary Angiography
  • Coronary Artery Disease / diagnosis*
  • Coronary Artery Disease / economics
  • Electrocardiography
  • Exercise Test
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Medicare / statistics & numerical data*
  • Myocardial Perfusion Imaging / economics
  • Myocardial Perfusion Imaging / methods*
  • Predictive Value of Tests
  • Reproducibility of Results
  • Retrospective Studies
  • United States