Clinical Implications of SPECT Appropriate Use Criteria

Background: Appropriate use criteria (AUC) have been developed for medical imaging studies in response to the growth in volume. However, these AUC have not been independently validated clinically. Objective: To determine the rate of abnormal stress single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) studies and subsequent follow-up revascularizations using AUC. Design: Retrospective review.  Patients: 280 patients referred for clinical reasons to stress SPECT-MPI. Methods: Patients were categorized according to the AUC categories of appropriate , inappropriate , or uncertain . Follow-up information regarding subsequent angiography and revascularization during the following 6 months was collected from the electronic medical record. Results: The mean patient age was 67 ± 11 years, and 36% were women. Overall, 63% of the patients fell in the appropriate category, 14% fell in the uncertain category, and 24% were in the inappropriate category. AUC-appr more...