How to reduce False Positives with SPECT MPI imaging

A false positive is an abnormal test result that unnecessarily promotes a patient to the next level of testing. It’s problematic, especially in today’s economic environment, because it places an additional cost burden on patients, the healthcare system, and insurance companies. It also exposes patients to higher risk invasive procedures, additional discomfort, and is ultimately an inefficient use of time.

As the healthcare industry moves closer toward value-based billing, there are even more pressing concerns. Soon the actual number of false positives will impact your facility’s quality scores, which will threaten the level of your reimbursements and affect your bottom line. Today there is significant pressure for medical providers to deliver scans that are of the highest quality. Here are some steps that help can help decrease the chance of a false positive:

Technical quality assessment

Once the prescribed isotope has been injected, it’s critical for the technologist to wait the suggested amount of time for blood pool and bowel clearance prior to imaging. Waiting the correct amount of time allows the technologist to evaluate the existence of any extraneous activity that may interfere with the heart uptake or imaging process. The technologist should also assure the rest images are satisfactory before proceeding to the stress phase of the exam.

Assessing raw data

After the technologist acquires the data, it should be assessed for quality. Motion can significantly impact the quality of a study to the point where the patient may have to be rescanned. While there is software that can perform motion correction, a study that can be checked and action taken while the patient is still present offers the best results.

Acquisition time

Acquisition time should vary by patient based on their specific factors in order to ensure the appropriate count volume for every patient. That’s why the cookie-cutter acquisition protocol isn’t always sufficient. The technologist must be able to accurately calculate the sufficient minimum dose and how long the study should last for each individual patient. The best way to ensure accuracy is with a camera that prompts the technologist with the calculation. Additionally, software like Tru-ACQ™ can automatically calculate the imaging time required on a per-patient basis at the time of imaging regardless of patient size or dose, thus allowing for reductions in imaging time and/or dose.

The impact of new technology

If your camera is ready to be replaced, you may want to consider a camera that is equipped with the tools to help you reduce the number of false positives. The Cardius X-ACT+ not only prompts the technologist at the appropriate quality control checkpoints, but it also includes the Tru-ACQ software package that calculates the appropriate imaging time based on individual patient variables.

Attenuation correction for SPECT MPI is also a major differentiator, providing PET-like diagnostic value. Patients have the potential for normal artifacts or variances simply due to the natural anatomy of the body. Correcting for that with a tissue map is the best way to see through the artifacts that create these false positives. Last but not least, the X-ACT+ is built for patient comfort, which will inevitably decrease the chance of a poor diagnostic study due to motion.

For more information on the Cardius X-ACT+ or any of the Digirad cameras, click here.


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