Published in:
01-02-2010 | Original Article
Direct comparison of rest and adenosine stress myocardial perfusion CT with rest and stress SPECT
Authors:
David R. Okada, BA, Brian B. Ghoshhajra, MD, Ron Blankstein, MD, Jose A. Rocha-Filho, MD, Leonid D. Shturman, MD, Ian S. Rogers, MD, Hiram G. Bezerra, MD, Ammar Sarwar, MD, Henry Gewirtz, MD, Udo Hoffmann, MD, PhD, Wilfred S. Mamuya, MD, PhD, Thomas J. Brady, MD, Ricardo C. Cury, MD
Published in:
Journal of Nuclear Cardiology
|
Issue 1/2010
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Introduction
We have recently described a technique for assessing myocardial perfusion using adenosine-mediated stress imaging (CTP) with dual source computed tomography. SPECT myocardial perfusion imaging (SPECT-MPI) is a widely utilized and extensively validated method for assessing myocardial perfusion. The aim of this study was to determine the level of agreement between CTP and SPECT-MPI at rest and under stress on a per-segment, per-vessel, and per-patient basis.
Methods
Forty-seven consecutive patients underwent CTP and SPECT-MPI. Perfusion images were interpreted using the 17 segment AHA model and were scored on a 0 (normal) to 3 (abnormal) scale. Summed rest and stress scores were calculated for each vascular territory and patient by adding corresponding segmental scores.
Results
On a per-segment basis (n = 799), CTP and SPECT-MPI demonstrated excellent correlation: Goodman-Kruskall γ = .59 (P < .0001) for stress and .75 (P < .0001) for rest. On a per-vessel basis (n = 141), CTP and SPECT-MPI summed scores demonstrated good correlation: Pearson r = .56 (P < .0001) for stress and .66 (P < .0001) for rest. On a per-patient basis (n = 47), CTP and SPECT-MPI demonstrated good correlation: Pearson r = .60 (P < .0001) for stress and .76 (P < .0001) for rest.
Conclusions
CTP compares favorably with SPECT-MPI for detection, extent, and severity of myocardial perfusion defects at rest and stress.