AIMS: Hybrid myocardial perfusion imaging with single photon emission computed tomography (SPECT) and CT coronary angiography (CCTA) has the potential to play a major role in patients with non-conclusive SPECT or CCTA results. We evaluated the performance of hybrid SPECT/CCTA vs. standalone SPECT and CCTA for the diagnosis of significant coronary artery disease (CAD) in patients with an intermediate to high pre-test likelihood of CAD. METHODS AND RESULTS: In total, 98 patients (mean age 62.5 ± 10.1 years, 68.4% male) with stable anginal complaints and a median pre-test likelihood of 87% (range 22-95%) were prospectively included in this study. Hybrid SPECT/CCTA was performed prior to conventional coronary angiography (CA) including fractional flow reserve (FFR) measurements. Hybrid analysis was performed by combined interpretation of SPECT and CCTA images. The sensitivity, specificity, positive (PPV), and negative (NPV) predictive values were calculated for standalone SPECT, CCTA, and hybrid SPECT/CCTA on per patient level, using an FFR <0.80 as a reference for significant CAD. Significant CAD was demonstrated in 56 patients (57.9%). Non-conclusive SPECT or CCTA results were found in 32 (32.7%) patients. SPECT had a sensitivity of 93%, specificity 79%, PPV 85%, and NPV 89%. CCTA had a sensitivity of 98%, specificity 62%, PPV 77%, and NPV 96%. Hybrid analysis of SPECT and CCTA improved the overall performance: sensitivity, specificity, PPV, and NPV for the presence of significant CAD to 96, 95, 96, and 95%, respectively. CONCLUSIONS: In > 40% of the patients with a high pre-test likelihood no significant CAD was demonstrated, emphasizing the value of accurate pre-treatment cardiovascular imaging. Hybrid SPECT/CCTA was able to accurately diagnose and exclude significant CAD surpassing standalone myocardial SPECT and CCTA, vs. a reference standard of FFR measurements.
AIMS: Hybrid myocardial perfusion imaging with single photon emission computed tomography (SPECT) and CT coronary angiography (CCTA) has the potential to play a major role in patients with non-conclusive SPECT or CCTA results. We evaluated the performance of hybrid SPECT/CCTA vs. standalone SPECT and CCTA for the diagnosis of significant coronary artery disease (CAD) in patients with an intermediate to high pre-test likelihood of CAD. METHODS AND RESULTS: In total, 98 patients (mean age 62.5 ± 10.1 years, 68.4% male) with stable anginal complaints and a median pre-test likelihood of 87% (range 22-95%) were prospectively included in this study. Hybrid SPECT/CCTA was performed prior to conventional coronary angiography (CA) including fractional flow reserve (FFR) measurements. Hybrid analysis was performed by combined interpretation of SPECT and CCTA images. The sensitivity, specificity, positive (PPV), and negative (NPV) predictive values were calculated for standalone SPECT, CCTA, and hybrid SPECT/CCTA on per patient level, using an FFR <0.80 as a reference for significant CAD. Significant CAD was demonstrated in 56 patients (57.9%). Non-conclusive SPECT or CCTA results were found in 32 (32.7%) patients. SPECT had a sensitivity of 93%, specificity 79%, PPV 85%, and NPV 89%. CCTA had a sensitivity of 98%, specificity 62%, PPV 77%, and NPV 96%. Hybrid analysis of SPECT and CCTA improved the overall performance: sensitivity, specificity, PPV, and NPV for the presence of significant CAD to 96, 95, 96, and 95%, respectively. CONCLUSIONS: In > 40% of the patients with a high pre-test likelihood no significant CAD was demonstrated, emphasizing the value of accurate pre-treatment cardiovascular imaging. Hybrid SPECT/CCTA was able to accurately diagnose and exclude significant CAD surpassing standalone myocardial SPECT and CCTA, vs. a reference standard of FFR measurements.
Authors: Elsemiek M Engbers; Jorik R Timmer; Jan Paul Ottervanger; Mohamed Mouden; Ad H J Oostdijk; Siert Knollema; Pieter L Jager Journal: J Nucl Cardiol Date: 2015-09-22 Impact factor: 5.952
Authors: Elsemiek M Engbers; Jorik R Timmer; Mohamed Mouden; Siert Knollema; Pieter L Jager; Jan Paul Ottervanger Journal: Eur Radiol Date: 2016-05-11 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: Riccardo Liga; Jan Vontobel; Daniele Rovai; Martina Marinelli; Chiara Caselli; Mikko Pietila; Anna Teresinska; Santiago Aguadé-Bruix; Maria Nazarena Pizzi; Giancarlo Todiere; Alessia Gimelli; Dante Chiappino; Paolo Marraccini; Stephen Schroeder; Tanja Drosch; Rosa Poddighe; Giancarlo Casolo; Constantinos Anagnostopoulos; Francesca Pugliese; Francois Rouzet; Dominique Le Guludec; Francesco Cappelli; Serafina Valente; Gian Franco Gensini; Camilla Zawaideh; Selene Capitanio; Gianmario Sambuceti; Fabio Marsico; Pasquale Perrone Filardi; Covadonga Fernández-Golfín; Luis M Rincón; Frank P Graner; Michiel A de Graaf; Julia Stehli; Eliana Reyes; Sandy Nkomo; Maija Mäki; Valentina Lorenzoni; Giuseppe Turchetti; Clara Carpeggiani; Stefano Puzzuoli; Maurizio Mangione; Paolo Marcheschi; Daniela Giannessi; Stephan Nekolla; Massimo Lombardi; Rosa Sicari; Arthur J H A Scholte; José L Zamorano; S Richard Underwood; Juhani Knuuti; Philipp A Kaufmann; Danilo Neglia; Oliver Gaemperli Journal: Eur Heart J Cardiovasc Imaging Date: 2016-03-18 Impact factor: 6.875