TY - JOUR
T1 - Diagnostic performance of fusion of myocardial perfusion imaging (MPI) and computed tomography coronary angiography
AU - Santana, Cesar A.
AU - Garcia, Ernest V.
AU - Faber, Tracy L.
AU - Sirineni, Gopi K.R.
AU - Esteves, Fabio P.
AU - Sanyal, Rupan
AU - Halkar, Raghuveer
AU - Ornelas, Mario
AU - Verdes, Liudmila
AU - Lerakis, Stamatios
AU - Ramos, Julie J.
AU - Aguadé-Bruix, Santiago
AU - Cuéllar, Hugo
AU - Candell-Riera, Jaume
AU - Raggi, Paolo
N1 - Funding Information:
This work was funded in part by General Electric healthcare LTD; National Institute of Health, NHLBI grant number K01 HL70422; Carlos III Institute; Thematic networks of cooperative research, (Red C03/01, RECAVA), and National Institute of Health; NHLBI grant number R01 HL085417. Two of the authors (TLF, EVG) receive royalties from the sale of the Emory Cardiac ToolboxTM utilized to conduct the research described in this article. The terms of this arrangement have been reviewed and approved by Emory University in accordance with it is conflict-of-interest practice.
PY - 2009
Y1 - 2009
N2 - Background: We evaluated the incremental diagnostic value of fusion images of coronary computed tomography angiography (CTA) and myocardial perfusion imaging (MPI) over MPI alone or MPI and CTA side-by-side to identify obstructive coronary artery disease (CAD > 50% stenosis) using invasive coronary angiography (ICA) as the gold standard. Methods: 50 subjects (36 men; 56 ± 11 years old) underwent rest-stress MPI and CTA within 12-26 days of each other. CTAs were performed with multi-detector CT-scanners (31 on 64-slice; and 19 on 16-slice). 37 patients underwent ICA while 13 subjects did not because of low (<5%) pre-test likelihood (LLK) of disease. Three blinded readers scored the images in sequential sessions using (1) MPI alone (2) MPI and CTA side-by-side, (3) fused CTA/MPI images. Results: One or more critical stenoses during ICA were found in 28 patients and non-critical stenoses were found in 9 patients. MPI, side-by-side MPI-CTA, and fused CTA/MPI showed the same normalcy rate (NR:13/13) in LLK subjects. The fusion technique performed better than MPI and MPI and CTA side-by-side for the presence of CAD in any vessel (overall area under the curve (AUC) for fused images: 0.89; P = .005 vs MPI, P = .04 vs side-by-side MPI-CTA) and for localization of CAD to the left anterior descending coronary artery (AUC: 0.82, P < .001 vs MPI; P = .007 vs side-by-side MPI-CTA). There was a non-significant trend for better detection of multi-vessel disease with fusion. Conclusions: Using ICA as the gold standard, fusion imaging provided incremental diagnostic information compared to MPI alone or side-by-side MPI-CTA for the diagnosis of obstructive CAD and for localization of CAD to the left anterior descending coronary artery.
AB - Background: We evaluated the incremental diagnostic value of fusion images of coronary computed tomography angiography (CTA) and myocardial perfusion imaging (MPI) over MPI alone or MPI and CTA side-by-side to identify obstructive coronary artery disease (CAD > 50% stenosis) using invasive coronary angiography (ICA) as the gold standard. Methods: 50 subjects (36 men; 56 ± 11 years old) underwent rest-stress MPI and CTA within 12-26 days of each other. CTAs were performed with multi-detector CT-scanners (31 on 64-slice; and 19 on 16-slice). 37 patients underwent ICA while 13 subjects did not because of low (<5%) pre-test likelihood (LLK) of disease. Three blinded readers scored the images in sequential sessions using (1) MPI alone (2) MPI and CTA side-by-side, (3) fused CTA/MPI images. Results: One or more critical stenoses during ICA were found in 28 patients and non-critical stenoses were found in 9 patients. MPI, side-by-side MPI-CTA, and fused CTA/MPI showed the same normalcy rate (NR:13/13) in LLK subjects. The fusion technique performed better than MPI and MPI and CTA side-by-side for the presence of CAD in any vessel (overall area under the curve (AUC) for fused images: 0.89; P = .005 vs MPI, P = .04 vs side-by-side MPI-CTA) and for localization of CAD to the left anterior descending coronary artery (AUC: 0.82, P < .001 vs MPI; P = .007 vs side-by-side MPI-CTA). There was a non-significant trend for better detection of multi-vessel disease with fusion. Conclusions: Using ICA as the gold standard, fusion imaging provided incremental diagnostic information compared to MPI alone or side-by-side MPI-CTA for the diagnosis of obstructive CAD and for localization of CAD to the left anterior descending coronary artery.
KW - Computed tomography (CT)
KW - Coronary artery disease
KW - Diagnostic and prognostic application
KW - Myocardial perfusion imaging
KW - PET imaging
KW - SPECT
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U2 - 10.1007/s12350-008-9019-z
DO - 10.1007/s12350-008-9019-z
M3 - Article
C2 - 19156478
AN - SCOPUS:67650004076
SN - 1071-3581
VL - 16
SP - 201
EP - 211
JO - Journal of Nuclear Cardiology
JF - Journal of Nuclear Cardiology
IS - 2
ER -