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First published online January 21, 2009, 10.2967/jnumed.108.053025
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Journal of Nuclear Medicine Vol. 50 No. 2 226-230
© 2009 by Society of Nuclear Medicine
doi: 10.2967/jnumed.108.053025

Brief Communication

Multimodality Cardiac Stress Testing: Combining Real-Time 3-Dimensional Echocardiography and Myocardial Perfusion SPECT

Vivek Walimbe1,2, Wael A. Jaber3, Mario J. Garcia4 and Raj Shekhar5

1 Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio; 2 Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; 3 Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio; 4 Non-Invasive Cardiology, Mount Sinai Hospital, New York, New York; and 5 Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland

Correspondence: For correspondence or reprints contact: Raj Shekhar, University of Maryland School of Medicine, 22 S. Greene St., Baltimore, MD 21201. E-mail: rshekhar{at}umm.edu

Early experience is described in implementing a new multimodality stress test for accurate correlation of complementary functional and perfusion information from real-time 3-dimensional (3D) echocardiography and SPECT, respectively. The proposed new multimodality stress test has the potential for simultaneously improving sensitivity and specificity in the detection of early coronary artery disease (CAD). Methods: Pre- and poststress real-time 3D echocardiography and SPECT images were acquired in 20 patients referred for CAD evaluation and processed using previously developed algorithms for automatic fusion and quantitative analysis of myocardial function and perfusion. All cases of CAD were diagnosed by reviewing quantitatively analyzed fused images, using newly developed software. Results: Real-time 3D echocardiography, SPECT, advance processing, and image review were successfully performed in all 20 patients. Compared with the angiographic findings in 12 patients, diagnosis based on fused images correctly identified 13 of 13 diseased arteries, compared with 11 of 13 identified by SPECT and 6 of 13 identified by echocardiography-based analysis. Conclusion: The results suggest the feasibility and potential effectiveness of novel multimodality stress testing.

Key Words: 3D echocardiography • myocardial perfusion SPECT • image registration • image segmentation • multimodality • image fusion • coronary artery disease

COPYRIGHT © 2009 by the Society of Nuclear Medicine, Inc.


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