scholarly journals The Evaluation of Left Ventricle Ischemic Extent in Patients with Significantly Suspicious Cardiovascular Disease by 99mTc-Sestamibi Dynamic SPECT/CT and Myocardial Perfusion Imaging: A Head-to-Head Comparison

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1101
Author(s):  
Hung-Pin Chan ◽  
Chin-Chuan Chang ◽  
Chin Hu ◽  
Wen-Hwa Wang ◽  
Nan-Jing Peng ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Left Ventricle ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Dynamic Spect ◽  
Artery Disease ◽  
Sensitivity Specificity ◽  
Photon Emission Computed Tomography ◽  
99Mtc Sestamibi

Heart disease is the second most common cause of mortality in Taiwan, mainly coronary artery disease (CAD).Quantitative coronary blood flow has been collected by dynamic single-photon emission computed tomography (Dynamic SPECT/CT) for CAD diagnosis in previous studies. However, few studies defined the extent of left ventricle (LV) ischemia on Dynamic SPECT/CT for predicting significant coronary artery stenosis. This study evaluates the extent of LV ischemic blockage in patients suspected of CAD who were referred by cardiologists. A total of 181 patients with suspected CAD were enrolled. They underwent 99mTc-Sestamibi (MIBI) Dynamic SPECT/CT survey before cardiac intervention. Dynamic SPECT/CT has better sensitivity (88%), specificity (96%), and accuracy (94%) compared with those of semi-quantitative MIBI MPI (more than 10%). Results indicated that5% of the LV ischemic extent can yield positive PCI results (>70% stenosis in coronary arteries) compared with the moderate abnormal extent of at least 15% of LV. When the percentage of combined moderate abnormal extent and ischemia extent of LV reaches 27.3%, positive PCI results may be indicated. This study revealed Dynamic SPECT/CT has greater sensitivity, specificity, and accuracy as compared with MPI. Thus, the severity of abnormal perfusion extent of LV on Dynamic SPECT/CT might be beneficial to predict positive PCI results in patients with significant suspicion CAD.

Coronary Flow Reserve Assessment in Patients with Cad by Dynamic Single-Photon Emission Computed Tomography

2017 ◽  
pp. 72-81
Author(s):  
A. V. Mochula ◽  
K. V. Zavadovsky ◽  
S. L. Andreev ◽  
A. L. Krylov ◽  
Yu. B. Lishmanov
Keyword(s):  
Coronary Artery ◽  
Sensitivity And Specificity ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Coronary Artery Diseases ◽  
Dynamic Spect ◽  
Flow Reserve ◽  
Artery Disease ◽  
Vessel Coronary Artery

Purpose: to assess the coronary flow reserve in patients with one,  two and multi-vessel coronary artery diseases by dynamic SPECT  using semiconductor (cadmium-zinctelluride)- based gamma camera.Material and methods.This work included 42 patients with stable  coronary artery diseases. The first group consisted of 12 (28.6%)  patients with single and two-vessel coronary artery disease (STCAD)  (8 males and 4 females; mean age 61.5 ± 3.8 years) with  intermediate (50–70%) and significant (>70%) coronary artery  stenosis. Second group included 30 (71.4%) patients with multi- vessel coronary artery diseases (MVCAD) (22 males and 8 females;  mean age 60.1 ± 4.3 years) with a lesion >70% in at least 2 major epicardial vessels according to invasive coronary angiography. All patients underwent rest-stress dynamic SPECT as well as conventional myocardial perfusion imaging with 99mTc-MIBI as a radiopharmaceutical. All scintigraphic images were  acquired on the hybrid SPECT/CT unit (GE Discovery NM/CT 570C).  Patient with STCAD underwent invasive FFR detection.Results.When comparing the results of MPI between the study  groups, there were no significant differences. ROC analysis showed  that the global MFR ≤ 1,42 allows to identify MVCAD with a  sensitivity and specificity 68% and 86,4%, for PSM, these values  are: 39.1% and 86.4% (AUC = 0.655, p < 0.05), respectively  (“gold” standard CAG). The sensitivity and specificity of the regional  MFR to identify the hemodynamic significance of coronary artery stenoses at a value of <1.33 was 100% (the “gold” standard of FFR). Most likely, high sensitivity and specificity in this case are associated with a small number of patients with true stenoses of FFR.Conclusion.The performance of standard MPI in combination with  dynamic single-photon emission computed tomography allows to  increase the diagnostic significance of the scintigraphic approach in  the evaluation of myocardial microcirculation disorders in multivessel coronary artery disease. Dynamic SPECT is a promising  method of noninvasive assessment of hemodynamic significance of  coronary artery stenoses.

Abstract 13023: Incremental Diagnostic Accuracy of Hybrid Single Photon Emission Computed Tomography Coronary Angiography in Suspected Coronary Artery Disease

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Shoko Hachiya ◽  
Hisanori Kosuge ◽  
Yasuhiro Fujita ◽  
Satoshi Hida ◽  
Taishiro Chikamori
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Diagnostic Accuracy ◽  
Hybrid Imaging ◽  
Single Photon ◽  
Photon Emission ◽  
Suspected Coronary Artery Disease ◽  
Emission Computed Tomography ◽  
Artery Disease ◽  
Photon Emission Computed Tomography

Background: Single-photon emission computed tomography (SPECT) and computed tomography coronary angiography (CTCA) are often undertaken independently in patients with suspected coronary artery disease (CAD). Hypothesis: We assessed the hypothesis that hybrid SPECT/CTCA imaging results in higher diagnostic accuracy than either method alone, allowing some false positives to be ruled out in the non-invasive testing phase. Methods: A total of 129 vessels (43 patients) were screened by SPECT with cadmium-zinc-telluride semiconductors and CTCA with a 256-detector row CT of the right coronary artery (RCA), left anterior descending artery (LAD), and left circumflex (LCX) segments. Patients who were diagnosed with myocardial ischemia then went on to undertake CAG. A diameter stenosis > 50% and any non-diagnostic segment in CTCA were considered abnormal. CAG results were classified as positive for stenosis when either a diameter stenosis was over 75% or fractional flow reserve was under 0.8. These were then compared to an image fusion of SPECT and CTCA data sets performed on a dedicated workstation. The results were categorised as a match or a mismatch (same as or different to the CAG, respectively). Results: Matched findings at SPECT, CTCA, and hybrid imaging were found in vessels of 75%, 67%, and 92%, respectively. Compared to the individual diagnostic performance of SPECT or CTCA in detecting significant CAD, hybrid imaging exhibited greater results in all of sensitivity, specificity, and accuracy (Fig 1). Segmental reclassification of perfusion abnormalities by hybrid imaging occurred at 10% for LAD, 56% for LCX, and 5% for RCA. Moreover, hybrid imaging allowed for accurate diagnosis of 22 vessels with severe calcification which CTCA alone could hardly evaluate correctly (Fig 2). Conclusions: Hybrid imaging showed higher diagnostic accuracy compared to single modalities, enabling physicians to make better decisions about the necessity for invasive CAG procedure.

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