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Annals of Nuclear Medicine

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01-08-2009 | Original Article

Clinical usefulness of novel cardiac MDCT/SPECT fusion image

Authors: Shinro Matsuo, Kenichi Nakajima, Nasima Akhter, Hiroshi Wakabayashi, Junichi Taki, Koichi Okuda, Seigo Kinuya

Published in: Annals of Nuclear Medicine | Issue 6/2009

Abstract

Background

We evaluated the relationship between computed tomography angiography (CTA) and SPECT, and assessed to determine the clinical usefulness of the fusion image using CTA and myocardial perfusion imaging (MPI).

Methods

Forty-one consecutive patients [after coronary artery bypass operation (n = 13) and suspected stenosis (n = 28)] underwent MPI and CTA. SPECT/CTA fused images were generated.

Results

In total, 687 segments including bypass graft in 164 coronary arteries were analyzed. Myocardial ischemia on MPI was observed in 11 patients among 28 with CTA abnormalities, one had both ischemia and infarction, and 7 had only infarction. Segment-based analysis showed that ischemia was found in 14 segments (24%) among 59 stenoses on CTA. Forty stenotic segments (69%) were not associated with perfusion abnormality. The rest 5 stenotic segments were considered equivocal (8%). A fusion image made it possible to associate perfusion defects with its corresponding coronary artery in 4 out of 5 equivocal lesions on side-by-side analysis. Patients with incremental diagnostic information on SPECT/CTA fusion (n = 4) had significant smaller coronary diameter than that of not-improved coronary vessels (2.0 ± 0.4 vs. 3.9 ± 0.4 mm, p = 0.001).

Conclusion

Cardiac fusion imaging accurately diagnosed functionally relevant coronary stenosis. SPECT/CTA fusion images in coronary artery disease may provide added diagnostic information on functional relevance of coronary artery disease.

Nishimura T, Nakajima K, Kusuoka H, Yamashina A, Nishimura S. Prognostic study of risk stratification among Japanese patients with ischemic heart disease using gated myocardial perfusion SPECT: J-ACCESS study. Eur J Nucl Med Mol Imaging. 2008;35:319–28.PubMedCrossRef

Tamaki N. Guidelines for clinical use of cardiac nuclear medicine (JCS 2005). Circ J. 2005;69(Suppl IV):1125–202.

Matsuo S, Nakajima K, Horie M, Nakae I, Nishimura T. Prognostic value of normal stress myocardial perfusion imaging in Japanese population: a study based on the J-ACCESS study. Circ J. 2008;72:611–7.PubMedCrossRef

Miller JM, Rochitte CE, Dewey M, Arbab-Zadeh A, Niinuma H, Gottlieb I, et al. Diagnostic performance of coronary angiography by 64-row CT. N Engl J Med. 2008;359:2324–36.PubMedCrossRef

Matsuo S, Nakamura Y, Matsumoto T, Nakae I, Nagatani H, Takazakura R, et al. Visual assessment of coronary artery stenosis with electrocardiographically-gated multislice computed tomography. Int J Cardiovasc Imaging. 2004;20:61–6.PubMedCrossRef

Gaemperli O, Schepis T, Valenta I, Husmann L, Scheffel H, Duerst V, et al. Cardiac image fusion from stand-alone SPECT and CT: clinical experience. J Nucl Med. 2007;48:696–703.PubMedCrossRef

Hacker M, Jakobs T, Hack N, Nikolaou K, Becker C, von Ziegler F, et al. Sixty-four slice spiral CT angiography does not predict the functional relevance of coronary artery stenoses in patients with stable angina. Eur J Nucl Med Mol Imaging. 2007;34:4–10.PubMedCrossRef

Hacker M, Jakobs T, Matthiesen F, Nikolaou K, Becker C, Knez A, et al. Combined functional and morphological imaging consisting of gated myocardial perfusion SPECT and 16-detector multislice spiral CT angiography in the noninvasive evaluation of coronary artery disease: first experiences. Clin Imaging. 2007;31:313–20.PubMedCrossRef

Nakajo H, Kumita S, Cho K, Kumazaki T. Three-dimensional registration of myocardial perfusion SPECT and CT coronary angiography. Ann Nucl Med. 2005;19:207–15.PubMedCrossRef

10.

Schindler TH, Magosaki N, Jeserich M, Oser U, Krause T, Fischer R, et al. Fusion imaging: combined visualization of 3D reconstructed coronary artery tree and 3D myocardial scintigraphic image in coronary artery disease. Int J Card Imaging. 1999;15:357–68.PubMedCrossRef

11.

Germano G, Kavanagh PB, Slomka PJ, Van Kriekinge SD, Pollard G, Berman DS. Quantitation in gated perfusion SPECT imaging: the Cedars-Sinai approach. J Nucl Cardiol. 2007;14:433–54.PubMedCrossRef

12.

Nishimura Y, Fukuchi K, Katafuchi T, Sagou M, Oka H, Ishida Y, et al. Superimposed display of coronary artery on gated myocardial perfusion scintigraphy. J Nucl Med. 2004;45:1444–9.PubMed

13.

Sato Y, Matsumoto N, Kato M, Inoue F, Horie T, Kusama J, et al. Noninvasive assessment of coronary artery disease by multislice spiral computed tomography using a new retrospectively ECG-gated image reconstruction technique. Circ J. 2003;67:401–5.PubMedCrossRef

14.

Austen WG, Edwards JE, Frye RL, Gensini GG, Gott VL, Griffith LS, et al. A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation. 1975;51(4 Suppl):5–40.PubMed

15.

Matsumoto N, Sato Y, Suzuki Y, Kunimasa T, Yoda S, Iida J, et al. Prognostic value of myocardial perfusion single-photon emission computed tomography for the prediction of future cardiac events in a Japanese population: a middle-term follow-up study. Circ J. 2007;71:1580–5.PubMedCrossRef

16.

Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK, et al. American Heart Association Writing Group on myocardial segmentation and registration for cardiac imaging standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation. 2002;105:539–42.PubMedCrossRef

17.

Malkerneker D, Brenner R, Martin WH, Sampson UK, Feurer ID, Kronenberg MW, et al. CT-based attenuation correction versus prone imaging to decrease equivocal interpretations of rest/stress Tc-99 m tetrofosmin SPECT MPI. J Nucl Cardiol. 2007;14:314–23.PubMedCrossRef

18.

Matsuo S, Matsumoto T, Nakae I, Koh T, Masuda D, Takada M, et al. Prognostic value of ECG-gated thallium-201 single-photon emission tomography in patients with coronary artery disease. Ann Nucl Med. 2004;18:617–22.PubMedCrossRef

19.

Matsuo S, Nakae I, Matsumoto T, Horie M. Impact of endothelial dysfunction on left ventricular remodeling after successful primary coronary angioplasty for acute myocardial infarction—analysis by quantitative ECG-gated SPECT. Ann Nucl Med. 2006;20:57–62.PubMedCrossRef

20.

Matsuo S, Nakamura Y, Tsutamoto T, Kinoshita M. Impairments of myocardial sympathetic activity may reflect the progression of myocardial damage or dysfunction in hypertrophic cardiomyopathy. J Nucl Cardiol. 2002;9:407–12.PubMedCrossRef

21.

Gaemperli O, Schepis T, Koepfli P, Valenta I, Soyka J, Leschka S, et al. Accuracy of 64-slice CT angiography for the detection of functionally relevant coronary stenoses as assessed with myocardial perfusion SPECT. Eur J Nucl Med Mol Imaging. 2007;34:1162–71.PubMedCrossRef

22.

Meijboom WB, Van Mieghem CA, van Pelt N, Weustink A, Pugliese F, Mollet NR, et al. Comprehensive assessment of coronary artery stenoses: computed tomography coronary angiography versus conventional coronary angiography and correlation with fractional flow reserve in patients with stable angina. J Am Coll Cardiol. 2008;52:636–43.PubMedCrossRef

23.

Tanihata S, Nishigaki K, Kawasaki M, Takemura G, Minatoguchi S, Fujiwara H. Outcomes of patients with stable low-risk coronary artery disease receiving medical- and PCI-preceding therapies in Japan: J-SAP study 1–1. Circ J. 2006;70:365–9.PubMedCrossRef

24.

Nakaura T, Utsunomiya D, Shiraishi S, Tomiguchi S, Honda T, Ogawa H, et al. Three-dimensional cardiac image fusion using new CT angiography and SPECT methods. AJR. 2005;185:1554–7.PubMedCrossRef

25.

Tanaka A, Shimada K, Yoshida K, Jissyo S, Tanaka H, Sakamoto M, et al. Non-invasive assessment of plaque rupture by 64-slice multidetector computed tomography—comparison with intravascular ultrasound. Circ J. 2008;72:1276–81.PubMedCrossRef

26.

Gaemperli O, Schepis T, Kalff V, Namdar M, Valenta I, Stefani L, et al. Validation of a new cardiac image fusion software for three-dimensional integration of myocardial perfusion SPECT and stand-alone 64-slice CT angiography. Eur J Nucl Med Mol Imaging. 2007;34:1097–106.PubMedCrossRef

27.

Faber TL, Santana CA, Garcia EV, Candell-Riera J, Folks RD, Peifer JW, et al. Three-dimensional fusion of coronary arteries with myocardial perfusion distributions: clinical validation. J Nucl Med. 2004;45:745–53.PubMed

Title: Clinical usefulness of novel cardiac MDCT/SPECT fusion image
Authors: Shinro Matsuo
Kenichi Nakajima
Nasima Akhter
Hiroshi Wakabayashi
Junichi Taki
Koichi Okuda
Seigo Kinuya
Publication date: 01-08-2009
Publisher: Springer Japan
Published in: Annals of Nuclear Medicine / Issue 6/2009
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI: https://doi.org/10.1007/s12149-009-0279-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical usefulness of novel cardiac MDCT/SPECT fusion image

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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