Comparative Analysis between SPECT Myocardial Perfusion Imaging and CT Coronary Angiography for Diagnosis of Coronary Artery Disease

The study aims to discuss the relationship and difference between myocardial perfusion imaging (MPI) using SPECT and CT coronary angiography (CTCA) for diagnosis of coronary artery disease (CAD). Five hundred and four cases undergoing MPI and CTCA were comparatively analyzed, including fifty six patients undergoing invasive coronary angiography in the same period. Among patients with negative MPI results, negative or positive CTCA occupied 84.7% or 15.3%, respectively. Among patients with positive MPI, positive or negative CTCA occupied 67.2% or 32.8%, respectively. Among patients with negative CTCA, negative or positive MPI occupied 94.4% or 5.6%, respectively. Among patients with positive CTCA, positive or negative MPI occupied 40.2% or 59.8%, respectively. Negative predictive value was relatively higher than the positive predictive value for positive CTCA eliminating or predicting abnormal haemodynamics. And there was no significant difference for sensitivity, specificity, and accuracy of MPI or CTCA in diagnosing CAD. Both MPI and CTCA have good diagnostic performance for CAD. They provide different and complementary information for diagnosis and evaluation of CAD, namely, detection of ischemia versus detection of atherosclerosis, which are quite different but have a definite internal link for each other.

[1]  L. Husmann,et al.  Very high coronary calcium score unmasks obstructive coronary artery disease in patients with normal SPECT MPI , 2011, Heart.

[2]  A. Lahiri,et al.  Comparative roles of cardiac CT and myocardial perfusion scintigraphy in the evaluation of patients with coronary artery disease: Competitive or complementary , 2010, Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology.

[3]  Gaurav Choudhary,et al.  The role of calcium score and CT angiography in the medical management of patients with normal myocardial perfusion imaging , 2010, Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology.

[4]  H. Alkadhi,et al.  Dual-source versus 64-section CT coronary angiography at lower heart rates: comparison of accuracy and radiation dose. , 2009, Radiology.

[5]  Jeroen J. Bax,et al.  The value of multi-slice-computed tomography coronary angiography for risk stratification , 2009, Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology.

[6]  R. Gropler,et al.  Coronary CT angiography (CCTA) and advances in CT plaque imaging , 2009, Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology.

[7]  Hatem Alkadhi,et al.  Prognostic value of multislice computed tomography and gated single-photon emission computed tomography in patients with suspected coronary artery disease. , 2009, Journal of the American College of Cardiology.

[8]  F. Eberli,et al.  Functionally relevant coronary artery disease: comparison of 64-section CT angiography with myocardial perfusion SPECT. , 2008, Radiology.

[9]  A. Takahashi,et al.  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 , 2008, Journal of Nuclear Medicine.

[10]  Jörg Hausleiter,et al.  Non-invasive coronary computed tomographic angiography for patients with suspected coronary artery disease: the Coronary Angiography by Computed Tomography with the Use of a Submillimeter resolution (CACTUS) trial. , 2007, European heart journal.

[11]  D. Spevack,et al.  Relationship between noninvasive coronary angiography with multislice computerized tomography and myocardial perfusion imaging. , 2006, Journal of the American College of Cardiology.

[12]  Manesh R. Patel,et al.  ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging. A report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group. , 2006, Journal of the American College of Radiology : JACR.

[13]  D. Berman,et al.  Roles of nuclear cardiology, cardiac computed tomography, and cardiac magnetic resonance: Noninvasive risk stratification and a conceptual framework for the selection of noninvasive imaging tests in patients with known or suspected coronary artery disease. , 2006, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[14]  M. Assadi,et al.  Frequency and severity of myocardial perfusion abnormalities using Tc-99m MIBI SPECT in cardiac syndrome X , 2006, BMC nuclear medicine.

[15]  Jeroen J. Bax,et al.  Relationship between noninvasive coronary angiography with multi-slice computed tomography and myocardial perfusion imaging. , 2006, Journal of the American College of Cardiology.

[16]  James C Carr,et al.  ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging: a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group, American College of Ra , 2006, Journal of the American College of Cardiology.

[17]  Jeroen J. Bax,et al.  Hemodynamic evaluation of saphenous vein coronary artery bypass grafts: Relative merits of doppler flow velocity and SPECT perfusion imaging , 2005, Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology.

[18]  D. Bonaduce,et al.  Influence of risk factors on coronary flow reserve in patients with 1-vessel coronary artery disease. , 2005, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[19]  William Wijns,et al.  Long-term clinical outcome after fractional flow reserve-guided percutaneous coronary intervention in patients with multivessel disease. , 2005, Journal of the American College of Cardiology.

[20]  A. Domínguez-Rodríguez,et al.  Cardiac Syndrome X: Diagnosis, Pathogenesis and Management , 2004, American journal of cardiovascular drugs : drugs, devices, and other interventions.

[21]  E. Antman,et al.  ACC/AHA/ASNC guidelines for the clinical use of cardiac radionuclide imaging--executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASNC Committee to Revise the 1995 Guidelines for the Clinical Use of Cardiac Radionucl , 2003, Journal of the American College of Cardiology.

[22]  E. Antman,et al.  ACC/AHA/ASNC guidelines for the clinical use of cardiac radionuclide imaging--executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASNC Committee to Revise the 1995 Guidelines for the Clinical Use of Cardiac Radionucl , 2003, Journal of the American College of Cardiology.

[23]  D. Berman,et al.  Comparison of the Short‐Term Survival Benefit Associated With Revascularization Compared With Medical Therapy in Patients With No Prior Coronary Artery Disease Undergoing Stress Myocardial Perfusion Single Photon Emission Computed Tomography , 2003, Circulation.

[24]  Jeroen J. Bax,et al.  Long-term prognosis after a normal exercise stress Tc-99m sestamibi SPECT study , 2003, Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology.

[25]  N. Pijls,et al.  False-negative myocardial scintigraphy in balanced three-vessel disease, revealed by coronary pressure measurement , 2003, International journal of cardiovascular interventions.

[26]  M. Cerqueira,et al.  Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. , 2002, Circulation.

[27]  David O. Williams,et al.  ACC/AHA Guidelines for Percutaneous Coronary Intervention (Revision of the 1993 PTCA Guidelines)—Executive Summary , 2001 .

[28]  A. Lahiri,et al.  The prognostic value of a normal Tc-99m sestamibi SPECT study in suspected coronary artery disease , 1999, Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology.

[29]  T. Ryan Guidelines for percutaneous transluminal coronary angioplasty. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee on Percutaneous Transluminal Coronary Angioplasty). , 1988, Journal of the American College of Cardiology.

[30]  R. Frye,et al.  A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. , 1975, Circulation.