OBJECTIVES: The aim of this study was to perform a head-to-head comparison between multi-slice computed tomography (MSCT) and myocardial perfusion imaging (MPI) in patients with an intermediate likelihood of coronary artery disease (CAD) and to compare non-invasive findings to invasive coronary angiography. BACKGROUND: Multi-slice computed tomography detects atherosclerosis, whereas MPI detects ischemia; how these 2 techniques compare in patients with an intermediate likelihood of CAD is unknown. METHODS: A total of 114 patients, mainly with intermediate likelihood of CAD, underwent both MSCT and MPI. The MSCT studies were classified as having no CAD, nonobstructive (<50% luminal narrowing) CAD, or obstructive CAD. Myocardial perfusion imaging examinations were classified as showing normal or abnormal (reversible and/or fixed defects). In a subset of 58 patients, invasive coronary angiography was performed. RESULTS: On the basis of the MSCT data, 41 patients (36%) were classified as having no CAD, of whom 90% had normal MPI. A total of 33 patients (29%) showed non-obstructive CAD, whereas at least 1 significant (> or =50% luminal narrowing) lesion was observed in the remaining 40 patients (35%). Only 45% of patients with an abnormal MSCT had abnormal MPI; even in patients with obstructive CAD on MSCT, 50% still had a normal MPI. In the subset of patients undergoing invasive angiography, the agreement with MSCT was excellent (90%). CONCLUSIONS: Myocardial perfusion imaging and MSCT provide different and complementary information on CAD, namely, detection of atherosclerosis versus detection of ischemia. As compared to invasive angiography, MSCT has a high accuracy for detecting CAD in patients with an intermediate likelihood of CAD.
OBJECTIVES: The aim of this study was to perform a head-to-head comparison between multi-slice computed tomography (MSCT) and myocardial perfusion imaging (MPI) in patients with an intermediate likelihood of coronary artery disease (CAD) and to compare non-invasive findings to invasive coronary angiography. BACKGROUND: Multi-slice computed tomography detects atherosclerosis, whereas MPI detects ischemia; how these 2 techniques compare in patients with an intermediate likelihood of CAD is unknown. METHODS: A total of 114 patients, mainly with intermediate likelihood of CAD, underwent both MSCT and MPI. The MSCT studies were classified as having no CAD, nonobstructive (<50% luminal narrowing) CAD, or obstructive CAD. Myocardial perfusion imaging examinations were classified as showing normal or abnormal (reversible and/or fixed defects). In a subset of 58 patients, invasive coronary angiography was performed. RESULTS: On the basis of the MSCT data, 41 patients (36%) were classified as having no CAD, of whom 90% had normal MPI. A total of 33 patients (29%) showed non-obstructive CAD, whereas at least 1 significant (> or =50% luminal narrowing) lesion was observed in the remaining 40 patients (35%). Only 45% of patients with an abnormal MSCT had abnormal MPI; even in patients with obstructive CAD on MSCT, 50% still had a normal MPI. In the subset of patients undergoing invasive angiography, the agreement with MSCT was excellent (90%). CONCLUSIONS: Myocardial perfusion imaging and MSCT provide different and complementary information on CAD, namely, detection of atherosclerosis versus detection of ischemia. As compared to invasive angiography, MSCT has a high accuracy for detecting CAD in patients with an intermediate likelihood of CAD.
Authors: Andrea L Vavere; Gregory G Simon; Richard T George; Carlos E Rochitte; Andrew E Arai; Julie M Miller; Marcello Di Carli; Armin Arbab-Zadeh; Armin A Zadeh; Marc Dewey; Hiroyuki Niinuma; Roger Laham; Frank J Rybicki; Joanne D Schuijf; Narinder Paul; John Hoe; Sachio Kuribyashi; Hajime Sakuma; Cesar Nomura; Tan Swee Yaw; Klaus F Kofoed; Kunihiro Yoshioka; Melvin E Clouse; Jeffrey Brinker; Christopher Cox; Joao A C Lima Journal: J Cardiovasc Comput Tomogr Date: 2011-11-12
Authors: J G J Groothuis; A M Beek; M R Meijerink; S L Brinckman; M B M Hofman; A C van Rossum Journal: Neth Heart J Date: 2010-05 Impact factor: 2.380
Authors: Carolina Valdiviezo; Marietta Ambrose; Vishal Mehra; Albert C Lardo; Joao A C Lima; Richard T George Journal: J Nucl Cardiol Date: 2010-12 Impact factor: 5.952