Abstract 1642: Head-to-Head Comparison of Myocardial Perfusion SPECT Imaging and Delayed Enhancement Magnetic Resonance Imaging to Detect Myocardial Infarction
PURPOSE: Direct visualization of myocardial infarction is possible by delayed enhancement MRI (DE-MRI). The method has been validated in animal studies and patients and is considered to be the reference method for infarct assessment. However, myocardial perfusion SPECT has remained the most common method to depict stress induced ischemia and gives simultaneous information on myocardial infarction. The accuracy of gated SPECT for infarction assessment has been under debate stating that SPECT has limited sensitivity. Therefore, the aim of this study was to determine the sensitivity and specificity of gated SPECT for infarct assessment using MRI as reference method.
METHODS: 96 patients (32 females) referred for myocardial perfusion SPECT imaging were included. A body weight adjusted dose of technetium labelled tetrofosmin was injected at rest and during adenosine infusion and gated SPECT images were aquired in all but 2 patients where SPECT were acquired without ECG-gating. In all patients, DE-MRI were performed the same day. All images were evaluated visually with the observers blinded to all clinical data and to the results of the other imaging study.
RESULTS: In 29 patients infarcts were visualized by MRI. Of these, 25 patients had infarct detected by gated SPECT. Thus, the sensitivity and specificity for infarct detection by gated SPECT on patient basis were 86% and 97%, respectively.
CONCLUSION:. This study has showed high sensitivity and very high specificity for gated SPECT on a patient basis for infarct detection. Thus, gated SPECT can be used for infarct detection with good accuracy in patients with suspected ischemic heart disease.