Document Detail


Integrated single-photon emission computed tomography and computed tomography coronary angiography for the assessment of hemodynamically significant coronary artery lesions.
MedLine Citation:
PMID:  17349885     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to assess the physiologic significance of coronary artery lesions with an integrated single-photon emission computed tomography (SPECT) and computed tomography coronary angiography (CTCA) device. BACKGROUND: Myocardial perfusion imaging (MPI) with SPECT is of value for assessing the physiologic significance of coronary lesions. Computed tomography coronary angiography is a new technique to noninvasively detect coronary stenosis, with high sensitivity and negative predictive value (NPV) but lower specificity and positive predictive value (PPV). The experimental SPECT/CTCA hybrid imaging device (Infinia gamma camera and LightSpeed16 CT, General Electric, Milwaukee, Wisconsin) enables concurrent assessment of coronary anatomy and myocardial perfusion. METHODS: Fifty-six patients with angina pectoris underwent single-session SPECT-MPI and CTCA with the hybrid device and coronary angiography (CA) within 4 weeks. The ability of fused SPECT/CTCA images to diagnose physiologically significant lesions showing >50% stenosis and reversible perfusion defects in the same territory was determined and compared with CTCA stand-alone. RESULTS: Of a total of 224 coronary segments in 56 patients, 12 patients and 54 segments (23%) were excluded from further analysis of CTCA. Overall, 170 coronary segments were evaluated. The sensitivity, specificity, PPV, and NPV of CTCA were 96%, 63%, 31%, and 99%, respectively, as compared with 96%, 95%, 77%, and 99%, respectively, for SPECT/CTCA. CONCLUSIONS: Hybrid SPECT/CTCA imaging results in improved specificity and PPV to detect hemodynamically significant coronary lesions in patients with chest pain. Single-photon emission computed tomography/CTCA might play a potentially important role in the noninvasive diagnosis of coronary artery disease and introduce an objective decision-making tool for assessing the need for interventions in each occluded vessel.
Authors:
Shmuel Rispler; Zohar Keidar; Eduard Ghersin; Ariel Roguin; Adrian Soil; Robert Dragu; Diana Litmanovich; Alex Frenkel; Doron Aronson; Ahuva Engel; Rafael Beyar; Ora Israel
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-02-26
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  49     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-12     Completed Date:  2007-04-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1059-67     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Technion-Israel Institute of Technology, Haifa, Israel. s_rispler@rambam.health.gov.il
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cohort Studies
Coronary Artery Disease / radiography*,  radionuclide imaging*
Female
Humans
Image Interpretation, Computer-Assisted*
Magnetic Resonance Angiography / methods*
Male
Middle Aged
Prospective Studies
Reproducibility of Results
Sensitivity and Specificity
Severity of Illness Index
Stroke Volume
Tomography, Emission-Computed, Single-Photon / methods*
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2007 Mar 13;49(10):1068-70   [PMID:  17349886 ]

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