Howard C. Lewin

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BACKGROUND The incremental prognostic value of post-stress left ventricular ejection fraction (EF) and volume over perfusion has not been investigated. METHODS AND RESULTS We identified 1680 consecutive patients who underwent rest Tl-201/stress Tc-99m sestamibi gated single photon emission computed tomography (SPECT) and who were followed-up for 569+/-106(More)
UNLABELLED We have developed a new, completely automatic 3-dimensional software approach to quantitative perfusion SPECT. The main features of the software are myocardial sampling based on an ellipsoid model; use of the entire count profile between the endocardial and epicardial surfaces; independence of the algorithm from myocardial shape, size, and(More)
UNLABELLED This study validates a new quantitative perfusion SPECT algorithm for the assessment of myocardial perfusion. The algorithm is not based on slices and provides fully 3-dimensional sampling and analysis independent of assumptions about the geometric shape of the left ventricle. METHODS Radiopharmaceutical- and sex-specific normal limits and(More)
Postexercise wall motion abnormality (WMA) in patients with normal resting myocardial perfusion may represent prolonged postischemic stunning, and may be related to the presence of severe angiographic coronary artery disease (CAD). This study assesses the diagnostic value of postexercise WMA by technetium-99m (Tc-99m) sestamibi gated single-photon emission(More)
OBJECTIVES The study compared the prognostic significance of myocardial perfusion single-photon emission computed tomography (SPECT) (MPS) in patients early and late after coronary artery bypass graft surgery (CABG). BACKGROUND The long-term effectiveness of CABG is limited by graft stenosis. The greatest incidence of graft occlusion occurs between five(More)
UNLABELLED Patient motion during myocardial perfusion SPECT can produce images that show artifactual perfusion defects. The relationship between the degree of motion and the extent of artifactual perfusion defects is not clear for either single- or double-head detectors. Using both single- and double-head detectors and quantitative perfusion SPECT (QPS)(More)
UNLABELLED This study validated a new automatic algorithm for assessment of lung-to-heart ratio (L/H) of radiotracers in myocardial perfusion SPECT and assessed the diagnostic value of (99m)Tc-sestamibi L/H after exercise. METHODS The new technique extracts a left ventricular region of interest (ROI) from a summed anterior projection image and generates a(More)
OBJECTIVES The study aim was to determine observational differences in costs of care by the coronary disease diagnostic test modality. BACKGROUND A number of diagnostic strategies are available with few data to compare the cost implications of the initial test choice. METHODS We prospectively enrolled 11,372 consecutive stable angina patients who were(More)
BACKGROUND Diabetics generally have more frequent and extensive silent myocardial ischemia than nondiabetics, increasing the importance of noninvasive detection of coronary artery disease (CAD) in this cohort. However, little is known regarding the diagnostic accuracy of myocardial perfusion single-photon emission computed tomography (SPECT) in patients(More)
BACKGROUND Little is known about the prognostic value of myocardial perfusion single photon emission computed tomography (SPECT) in patients with remote prior myocardial infarction (MI). METHODS AND RESULTS We identified 1413 consecutive patients with remote prior MI who underwent rest-stress myocardial perfusion SPECT. Semiquantitative visual analysis of(More)