The Evaluation of Left Ventricle Ischemic Extent in Patients with Significantly Suspicious Cardiovascular Disease by 99mTc-Sestamibi Dynamic SPECT/CT and Myocardial Perfusion Imaging: A Head-to-Head Comparison.
Hung-Pin ChanChin-Chuan ChangChin HuWen-Hwa WangNan-Jing PengYu-Chang TyanMing-Hui YangPublished in: Diagnostics (Basel, Switzerland) (2021)
Heart disease is the second most common cause of mortality in Taiwan, mainly coronary artery disease (CAD).Quantitative coronary blood flow has been collected by dynamic single-photon emission computed tomography (Dynamic SPECT/CT) for CAD diagnosis in previous studies. However, few studies defined the extent of left ventricle (LV) ischemia on Dynamic SPECT/CT for predicting significant coronary artery stenosis. This study evaluates the extent of LV ischemic blockage in patients suspected of CAD who were referred by cardiologists. A total of 181 patients with suspected CAD were enrolled. They underwent 99mTc-Sestamibi (MIBI) Dynamic SPECT/CT survey before cardiac intervention. Dynamic SPECT/CT has better sensitivity (88%), specificity (96%), and accuracy (94%) compared with those of semi-quantitative MIBI MPI (more than 10%). Results indicated that5% of the LV ischemic extent can yield positive PCI results (>70% stenosis in coronary arteries) compared with the moderate abnormal extent of at least 15% of LV. When the percentage of combined moderate abnormal extent and ischemia extent of LV reaches 27.3%, positive PCI results may be indicated. This study revealed Dynamic SPECT/CT has greater sensitivity, specificity, and accuracy as compared with MPI. Thus, the severity of abnormal perfusion extent of LV on Dynamic SPECT/CT might be beneficial to predict positive PCI results in patients with significant suspicion CAD.
Keyphrases
- coronary artery disease
- computed tomography
- dual energy
- image quality
- contrast enhanced
- percutaneous coronary intervention
- cardiovascular events
- coronary artery
- positron emission tomography
- pet ct
- coronary artery bypass grafting
- blood flow
- cardiovascular disease
- pulmonary artery
- magnetic resonance imaging
- acute myocardial infarction
- pulmonary hypertension
- high resolution
- acute coronary syndrome
- randomized controlled trial
- st segment elevation myocardial infarction
- magnetic resonance
- end stage renal disease
- high intensity
- antiplatelet therapy
- cross sectional
- mitral valve
- st elevation myocardial infarction
- pulmonary embolism
- cerebral ischemia
- left ventricular
- mass spectrometry
- pulmonary arterial hypertension
- subarachnoid hemorrhage
- aortic valve
- single cell
- coronary artery bypass