RT Journal Article
SR Electronic
T1 Cardiac Image Fusion from Stand-Alone SPECT and CT: Clinical Experience
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 696
OP 703
DO 10.2967/jnumed.106.037606
VO 48
IS 5
A1 Oliver Gaemperli
A1 Tiziano Schepis
A1 Ines Valenta
A1 Lars Husmann
A1 Hans Scheffel
A1 Victor Duerst
A1 Franz R. Eberli
A1 Thomas F. Luscher
A1 Hatem Alkadhi
A1 Philipp A. Kaufmann
YR 2007
UL http://jnm.snmjournals.org/content/48/5/696.abstract
AB Myocardial perfusion imaging with SPECT (SPECT-MPI) and 64-slice CT angiography (CTA) are both established techniques for the noninvasive evaluation of coronary artery disease (CAD). Three-dimensional (3D) SPECT/CT image fusion may offer an incremental diagnostic value by integrating both sets of information. We report our first clinical experiences with fused 3D SPECT/CT in CAD patients. Methods: Thirty-eight consecutive patients with at least 1 perfusion defect on SPECT-MPI (1-d adenosine stress/rest SPECT with 99mTc-tetrofosmin) and 64-slice CTA were included. 3D volume-rendered fused SPECT/CT images were generated and compared with the findings from the side-by-side analysis with regard to coronary lesion interpretation by assigning the perfusion defects to their corresponding coronary lesion. Results: The fused SPECT/CT images added information on pathophysiologic lesion severity in 27 coronary stenoses (22%) of 12 patients (29%) (P < 0.001). Among 40 equivocal lesions on side-by-side analysis, the fused interpretation confirmed hemodynamic significance in 14 lesions and excluded functional relevance in 10 lesions. In 3 lesions, assignment of perfusion defect and coronary lesion appeared to be reliable on side-by-side analysis but proved to be inaccurate on fused interpretation. Added diagnostic information by SPECT/CT was more commonly found in patients with stenoses of small vessels (P = 0.004) and involvement of diagonal branches (P = 0.01). Conclusion: In addition to being intuitively convincing, 3D SPECT/CT fusion images in CAD may provide added diagnostic information on the functional relevance of coronary artery lesions.