Abstract 11729: Stress Computed Tomography Myocardial Perfusion is Superior to Single-Photon Emission Computed Tomography for Detection of Myocardial Ischemia
Introduction: Adenosine stress computed tomography myocardial perfusion imaging (CTP) has been developed to detect myocardial ischemia; however, the diagnostic accuracy has not been fully evaluated with comparison to single-photon emission computed tomography (SPECT). The purpose of this study was to compare the accuracy between CTP and SPECT for the assessment of functionally significant coronary artery disease (CAD).
Methods: A total of 93 coronary artery lesions were enrolled from 31 patients (mean age 71.0±8.4 years, and 16% female), who had at least one vessel detected with ≥50% stenosis by computed tomography coronary angiography (CTA). These lesions were considered for non-urgent revascularization, and all patients underwent SPECT, adenosine stress CTP by using 320-row detector, and followed by invasive coronary angiography (ICA). Reversible perfusion deficits of SPECT and/or CTP images were diagnosed as positive for myocardial ischemia. Fractional flow reserve (FFR) was determined in 35 vessels with ≥50% stenosis upon visual assessment of ICA images. Based on positive findings with either ≥99% stenosis of ICA or ≤0.8 of FFR, diagnostic accuracy was compared between CTP and SPECT.
Results: A total of 78 vessels were eligible to assess significance of CAD. Significant CAD was diagnosed by either ICA (14%) or FFR (86%) in 22 lesions of 16 patients. Mean FFR of significant CAD was 0.72. The sensitivity, specificity, positive, negative predictive values and accuracy for CTP to detect significant CAD were 59%, 96%, 87%, 86% and 86% in the per vessel/territory analysis, respectively. These values for SPECT were 18%, 93%, 50%, 74% and 72%, respectively.
Conclusions: This study demonstrated that the diagnostic accuracy of CTP was superior to that of SPECT, especially in the sensitivity and positive predictive value to detect significant CAD. Adenosine stress CTP is useful for noninvasive diagnosis of coronary artery stenosis and its functional significance.
Author Disclosures: Y. Ueki: None.
- © 2014 by American Heart Association, Inc.