| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | RSS | TABLE OF CONTENTS |
|
|
|
||||||||
|
||||||||||
Clinical Investigations |
1 Department of Nuclear Medicine, University of Munich, Munich, Germany
2 Department of Radiology, University of Munich, Munich, Germany
3 Department of Neurology, University of Munich, Munich, Germany
4 Department of Cardiology, University of Munich, Munich, Germany
Compared with conventional coronary angiography, spiral multidetector CT (MDCT) angiography has delivered promising accuracy in the detection and validation of coronary lesions. Myocardial perfusion imaging (MPI) using SPECT is an established method for noninvasively assessing the functional significance of coronary stenoses and delivers valuable information for risk stratification. This retrospective analysis compared the accuracies of MDCT angiography and MPI in the detection of hemodynamically relevant lesions of the coronary arteries. Methods: Twenty-five patients with suspected or known coronary artery disease were studied. Electrocardiographically gated MPI and 16-MDCT angiography were performed. Myocardial perfusion images were analyzed by 2 experienced observers, and reversible and fixed perfusion defects were detected and allocated to their corresponding coronary vessels. For the evaluation of MDCT angiography, image quality was determined, and lesions 
50% and luminal narrowing < 50% were visually assessed and characterized by 2 independent observers unaware of the results of MPI. Results: Ninety-nine coronary vessels were analyzed, and the quality of MDCT angiography images was assessed for 330 coronary segments. Coronary artery diameter was interpretable for 231 (70%) of 330 segments, whereas in 99 (30%) of 330 segments, vessel diameter could not be evaluated because of heavy calcifications, blurring, motion artifacts, or intracoronary stents. MDCT angiography detected stenoses 50% in 15 of 100 coronary arteries. Eight (53%) of 15 stenoses 50% showed reversible or fixed perfusion defects in the corresponding myocardial areas on MPI. Sensitivity, specificity, and negative and positive predictive values were 100%, 87%, 100%, and 29%, respectively, for the ability of MDCT angiography to detect reversible perfusion defects in the corresponding myocardial areas. Conclusion: MDCT angiography detected myocardial ischemia, as defined by reversible perfusion defects on MPI, with a positive predictive value of 29% in a nonselected study cohort. Compared with MPI alone, MDCT angiography added important morphologic information, but MPI remains mandatory for evaluating the functional relevance of coronary artery lesions.
Key Words: multidetector CT angiography • myocardial SPECT • coronary artery disease
Related articles in JNM:
This article has been cited by other articles:
|
|
 |
|
  M. S. Javadi, R. Lautamaki, J. Merrill, C. Voicu, W. Epley, G. McBride, and F. M. Bengel Definition of Vascular Territories on Myocardial Perfusion Images by Integration with True Coronary Anatomy: A Hybrid PET/CT Analysis J. Nucl. Med., February 1, 2010; 51(2): 198 - 203. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K Nieman, T Galema, A Weustink, L Neefjes, A Moelker, P Musters, R de Visser, N Mollet, H Boersma, and P J de Feijter Computed tomography versus exercise electrocardiography in patients with stable chest complaints: real-world experiences from a fast-track chest pain clinic Heart, October 15, 2009; 95(20): 1669 - 1675. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K-R Chiou, W-C Huang, N-J Peng, Y-L Huang, S-H Hsiao, K-H Chen, and M-T Wu Dual-phase multi-detector computed tomography assesses jeopardised and infarcted myocardium subtending infarct-related artery early after acute myocardial infarction Heart, September 15, 2009; 95(18): 1495 - 1501. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Uebleis, A. Becker, I. Griesshammer, P. Cumming, C. Becker, M. Schmidt, P. Bartenstein, and M. Hacker Stable Coronary Artery Disease: Prognostic Value of Myocardial Perfusion SPECT in Relation to Coronary Calcium Scoring--Long-term Follow-up Radiology, September 1, 2009; 252(3): 682 - 690. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Husmann, B. A. Herzog, O. Gaemperli, F. Tatsugami, N. Burkhard, I. Valenta, P. Veit-Haibach, C. A. Wyss, U. Landmesser, and P. A. Kaufmann Diagnostic accuracy of computed tomography coronary angiography and evaluation of stress-only single-photon emission computed tomography/computed tomography hybrid imaging: comparison of prospective electrocardiogram-triggering vs. retrospective gating Eur. Heart J., March 1, 2009; 30(5): 600 - 607. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. B. Meijboom, C. A.G. Van Mieghem, N. van Pelt, A. Weustink, F. Pugliese, N. R. Mollet, E. Boersma, E. Regar, R. J. van Geuns, P. J. de Jaegere, et al. Comprehensive Assessment of Coronary Artery Stenoses: Computed Tomography Coronary Angiography Versus Conventional Coronary Angiography and Correlation With Fractional Flow Reserve in Patients With Stable Angina J. Am. Coll. Cardiol., August 19, 2008; 52(8): 636 - 643. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Gaemperli, T. Schepis, I. Valenta, P. Koepfli, L. Husmann, H. Scheffel, S. Leschka, F. R. Eberli, T. F. Luscher, H. Alkadhi, et al. Functionally Relevant Coronary Artery Disease: Comparison of 64-Section CT Angiography with Myocardial Perfusion SPECT Radiology, August 1, 2008; 248(2): 414 - 423. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Sato, M. Hiroe, M. Tamura, H. Ohigashi, T. Nozato, H. Hikita, A. Takahashi, K. Aonuma, and M. Isobe Quantitative Measures of Coronary Stenosis Severity by 64-Slice CT Angiography and Relation to Physiologic Significance of Perfusion in Nonobese Patients: Comparison with Stress Myocardial Perfusion Imaging J. Nucl. Med., April 1, 2008; 49(4): 564 - 572. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Dewey, B. Hamm, H-P. Dubel, and W. Rutsch Multislice computed tomography coronary angiography for triaging patients with positive radionuclide myocardial perfusion imaging QJM, January 1, 2008; 101(1): 65 - 67. [Full Text] [PDF]
|
|
|
|
|
|
J. J. Mahmarian Computed Tomography Coronary Angiography as an Anatomic Basis for Risk Stratification: Deja Vu or Something New? J. Am. Coll. Cardiol., September 18, 2007; 50(12): 1171 - 1173. [Full Text] [PDF]
|
|
|
|
 |
|
 A. J. Einstein, K. W. Moser, R. C. Thompson, M. D. Cerqueira, and M. J. Henzlova Radiation Dose to Patients From Cardiac Diagnostic Imaging Circulation, September 11, 2007; 116(11): 1290 - 1305. [Full Text] [PDF]
|
|
|
|
|
|
M. F. Di Carli, S. Dorbala, J. Meserve, G. El Fakhri, A. Sitek, and S. C. Moore Clinical Myocardial Perfusion PET/CT J. Nucl. Med., May 1, 2007; 48(5): 783 - 793. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. J. Bax, S. E. Inzucchi, R. O. Bonow, J. D. Schuijf, M. R. Freeman, E. J. Barrett, and on behalf of the Global Dialogue Group for the Eva Cardiac Imaging for Risk Stratification in Diabetes Diabetes Care, May 1, 2007; 30(5): 1295 - 1304. [Full Text] [PDF]
|
|
|
|
|
|
M. F. Di Carli and R. Hachamovitch New Technology for Noninvasive Evaluation of Coronary Artery Disease Circulation, March 20, 2007; 115(11): 1464 - 1480. [Full Text] [PDF]
|
|
|
|
|
|
S. Rispler, Z. Keidar, E. Ghersin, A. Roguin, A. Soil, R. Dragu, D. Litmanovich, A. Frenkel, D. Aronson, A. Engel, et al. Integrated Single-Photon Emission Computed Tomography and Computed Tomography Coronary Angiography for the Assessment of Hemodynamically Significant Coronary Artery Lesions J. Am. Coll. Cardiol., March 13, 2007; 49(10): 1059 - 1067. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Dorbala, R. Hachamovitch, and M. F. Di Carli Myocardial Perfusion Imaging and Multidetector Computed Tomographic Coronary Angiography: Appropriate for All Patients With Suspected Coronary Artery Disease? J. Am. Coll. Cardiol., December 19, 2006; 48(12): 2515 - 2517. [Full Text] [PDF]
|
|
|
|
|
|
J. D. Schuijf, W. Wijns, J. W. Jukema, D. E. Atsma, A. de Roos, H. J. Lamb, M. P.M. Stokkel, P. Dibbets-Schneider, I. Decramer, P. De Bondt, et al. Relationship Between Noninvasive Coronary Angiography With Multi-Slice Computed Tomography and Myocardial Perfusion Imaging J. Am. Coll. Cardiol., December 19, 2006; 48(12): 2508 - 2514. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Schuijf, W. Wijns, J. W. Jukema, I. DeCramer, D. E. Atsma, A. de Roos, M. P.M. Stokkel, P. Dibbets-Schneider, E. E. van der Wall, and J. J. Bax A Comparative Regional Analysis of Coronary Atherosclerosis and Calcium Score on Multislice CT Versus Myocardial Perfusion on SPECT J. Nucl. Med., November 1, 2006; 47(11): 1749 - 1755. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. F. Di Carli CT Coronary Angiography: Where Does It Fit? J. Nucl. Med., September 1, 2006; 47(9): 1397 - 1399. [Full Text] [PDF]
|
|
|
|
|
|
R. T. George, C. Silva, M. A.S. Cordeiro, A. DiPaula, D. R. Thompson, W. F. McCarthy, T. Ichihara, J. A.C. Lima, and A. C. Lardo Multidetector Computed Tomography Myocardial Perfusion Imaging During Adenosine Stress J. Am. Coll. Cardiol., July 4, 2006; 48(1): 153 - 160. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | RSS | TABLE OF CONTENTS |
| JOURNAL OF NUCLEAR MEDICINE TECHNOLOGY | THE JOURNAL OF NUCLEAR MEDICINE |
