Diagnostic Performance of Coronary CT Angiography, Stress Dual-Energy CT Perfusion, and Stress Perfusion Single-Photon Emission Computed Tomography for Coronary Artery Disease: Comparison with Combined Invasive Coronary Angiography and Stress Perfusion Ca.
10.3348/kjr.2017.18.3.476
- Author:
Hyun Woo CHUNG
1
;
Sung Min KO
;
Hweung Kon HWANG
;
Young SO
;
Jeong Geun YI
;
Eun Jeong LEE
Author Information
1. Department of Nuclear Medicine, Konkuk University Medical Center, Research Institute of Biomedical Science, Konkuk University School of Medicine, Seoul 05030, Korea.
- Publication Type:Original Article
- Keywords:
Coronary artery disease;
Myocardium;
CT angiography;
CT perfusion;
Adenosine stress;
Stress imaging;
SPECT;
MRI;
Dual-energy CT
- MeSH:
Angiography*;
Area Under Curve;
Constriction, Pathologic;
Coronary Angiography*;
Coronary Artery Disease*;
Coronary Stenosis;
Coronary Vessels*;
Humans;
Magnetic Resonance Imaging*;
Myocardial Perfusion Imaging;
Myocardium;
Perfusion*;
Retrospective Studies;
ROC Curve;
Sensitivity and Specificity;
Tomography, Emission-Computed*;
Tomography, Emission-Computed, Single-Photon
- From:Korean Journal of Radiology
2017;18(3):476-486
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To investigate the diagnostic performance of coronary computed tomography angiography (CCTA), stress dual-energy computed tomography perfusion (DE-CTP), stress perfusion single-photon emission computed tomography (SPECT), and the combinations of CCTA with myocardial perfusion imaging (CCTA + DE-CTP and CCTA + SPECT) for identifying coronary artery stenosis that causes myocardial hypoperfusion. Combined invasive coronary angiography (ICA) and stress perfusion cardiac magnetic resonance (SP-CMR) imaging are used as the reference standard. MATERIALS AND METHODS: We retrospectively reviewed the records of 25 patients with suspected coronary artery disease, who underwent CCTA, DE-CTP, SPECT, SP-CMR, and ICA. The reference standard was defined as ≥ 50% stenosis by ICA, with a corresponding myocardial hypoperfusion on SP-CMR. RESULTS: For per-vascular territory analysis, the sensitivities of CCTA, DE-CTP, SPECT, CCTA + DE-CTP, and CCTA + SPECT were 96, 96, 68, 93, and 68%, respectively, and specificities were 72, 75, 89, 85, and 94%, respectively. The areas under the receiver operating characteristic curve (AUCs) were 0.84 ± 0.05, 0.85 ± 0.05, 0.79 ± 0.06, 0.89 ± 0.04, and 0.81 ± 0.06, respectively. For per-patient analysis, the sensitivities of CCTA, DE-CTP, SPECT, CCTA + DE-CTP, and CCTA + SPECT were 100, 100, 89, 100, and 83%, respectively; the specificities were 14, 43, 57, 43, and 57%, respectively; and the AUCs were 0.57 ± 0.13, 0.71 ± 0.11, 0.73 ± 0.11, 0.71 ± 0.11, and 0.70 ± 0.11, respectively. CONCLUSION: The combination of CCTA and DE-CTP enhances specificity without a loss of sensitivity for detecting hemodynamically significant coronary artery stenosis, as defined by combined ICA and SP-CMR.
