AIMS: To evaluate the diagnostic accuracy of a combined non-invasive assessment of coronary artery disease with coronary CT angiography (CTA) and myocardial perfusion imaging (MPI) for the detection of flow-limiting coronary stenoses and its potential as a gatekeeper for invasive examination and treatment. METHODS AND RESULTS: In 78 patients (mean age 65 +/- 9 years) referred for coronary angiography (CA), additional CTA and MPI (using single-photon emission-computed tomography) were performed and the findings not communicated. Detection of flow-limiting stenoses (justifying revascularization) by the combination of CTA and MPI (CTA/MPI) was compared with the combination of quantitative coronary angiography (QCA) plus MPI (QCA/MPI), which served as standard of reference. The findings of both combinations were related to the treatment strategy (revascularization vs. medical treatment) chosen in the catheterization laboratory based on the CA findings. Sensitivity, specificity, positive and negative predictive value, and accuracy of CTA/MPI for the detection of flow-limiting coronary stenoses were 100% each. More than half of revascularization procedures (21/40, 53%) was performed in patients without flow-limiting stenoses and 76% (47/62) of revascularized vessels were not associated with ischaemia on MPI. CONCLUSION: The combined non-invasive approach CTA/MPI has an excellent accuracy to detect flow-limiting coronary stenoses compared with QCA/MPI and its use as a gatekeeper appears to make a substantial part of revascularization procedures redundant.
AIMS: To evaluate the diagnostic accuracy of a combined non-invasive assessment of coronary artery disease with coronary CT angiography (CTA) and myocardial perfusion imaging (MPI) for the detection of flow-limiting coronary stenoses and its potential as a gatekeeper for invasive examination and treatment. METHODS AND RESULTS: In 78 patients (mean age 65 +/- 9 years) referred for coronary angiography (CA), additional CTA and MPI (using single-photon emission-computed tomography) were performed and the findings not communicated. Detection of flow-limiting stenoses (justifying revascularization) by the combination of CTA and MPI (CTA/MPI) was compared with the combination of quantitative coronary angiography (QCA) plus MPI (QCA/MPI), which served as standard of reference. The findings of both combinations were related to the treatment strategy (revascularization vs. medical treatment) chosen in the catheterization laboratory based on the CA findings. Sensitivity, specificity, positive and negative predictive value, and accuracy of CTA/MPI for the detection of flow-limiting coronary stenoses were 100% each. More than half of revascularization procedures (21/40, 53%) was performed in patients without flow-limiting stenoses and 76% (47/62) of revascularized vessels were not associated with ischaemia on MPI. CONCLUSION: The combined non-invasive approach CTA/MPI has an excellent accuracy to detect flow-limiting coronary stenoses compared with QCA/MPI and its use as a gatekeeper appears to make a substantial part of revascularization procedures redundant.
Authors: Michael Fiechter; Jelena R Ghadri; Mathias Wolfrum; Silke M Kuest; Aju P Pazhenkottil; Rene N Nkoulou; Bernhard A Herzog; Cathérine Gebhard; Tobias A Fuchs; Oliver Gaemperli; Philipp A Kaufmann Journal: Eur J Nucl Med Mol Imaging Date: 2011-12-06 Impact factor: 9.236
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Authors: Arthur Nasis; Brian S Ko; Michael C Leung; Paul R Antonis; Dee Nandurkar; Dennis T Wong; Leo Kyi; James D Cameron; John M Troupis; Ian T Meredith; Sujith K Seneviratne Journal: Eur Radiol Date: 2013-02-21 Impact factor: 5.315
Authors: Asim Rizvi; Donghee Han; Ibrahim Danad; Bríain Ó Hartaigh; Ji Hyun Lee; Heidi Gransar; Wijnand J Stuijfzand; Hadi Mirhedayati Roudsari; Mahn Won Park; Jackie Szymonifka; Hyuk-Jae Chang; Erica C Jones; Paul Knaapen; Fay Y Lin; James K Min; Jessica M Peña Journal: JACC Cardiovasc Imaging Date: 2017-08-16
Authors: Michael Fiechter; Jelena R Ghadri; Silke M Kuest; Aju P Pazhenkottil; Mathias Wolfrum; Rene N Nkoulou; Robert Goetti; Oliver Gaemperli; Philipp A Kaufmann Journal: Eur J Nucl Med Mol Imaging Date: 2011-07-15 Impact factor: 9.236
Authors: Si Eun Lee; Kyunghwa Han; Jin Hur; Young Jin Kim; Hye-Jeong Lee; Yoo Jin Hong; Dong Jin Im; Byoung Wook Choi Journal: Eur Radiol Date: 2017-12-08 Impact factor: 5.315
Authors: Bernhard Bischoff; Fabian Bamberg; Roy Marcus; Florian Schwarz; Hans-Christoph Becker; Alexander Becker; Maximilian Reiser; Konstantin Nikolaou Journal: Int J Cardiovasc Imaging Date: 2012-06-20 Impact factor: 2.357
Authors: Viviany R Taqueti; Sharmila Dorbala; David Wolinsky; Brian Abbott; Gary V Heller; Timothy M Bateman; Jennifer H Mieres; Lawrence M Phillips; Nanette K Wenger; Leslee J Shaw Journal: J Nucl Cardiol Date: 2017-06-05 Impact factor: 5.952