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05.05.2016 | Original Article | Ausgabe 5/2017

Journal of Nuclear Cardiology 5/2017

Comparison of coronary flow reserve estimated by dynamic radionuclide SPECT and multi-detector x-ray CT

Zeitschrift:
Journal of Nuclear Cardiology > Ausgabe 5/2017
Autoren:
PhD Cecilia Marini, MD Sara Seitun, MD Camilla Zawaideh, MD Matteo Bauckneht, MD Margherita Castiglione Morelli, PhD Pietro Ameri, MD Giulia Ferrarazzo, MD Irilda Budaj, MD Manrico Balbi, MD Francesco Fiz, MD Sara Boccalini, MD Athena Galletto Pregliasco, MD Ambra Buschiazzo, MD Alice Saracco, PhD Maria Claudia Bagnara, MD Paolo Bruzzi, MD Claudio Brunelli, MD Carlo Ferro, MD Gian Paolo Bezante, MD Gianmario Sambuceti
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s12350-016-0492-5) contains supplementary material, which is available to authorized users.
See related editorial, doi: 10.​1007/​s12350-016-0528-x.

Abstract

Background

Recent technical advances in multi-detector computed tomography (MDCT) allow for assessment of coronary flow reserve (CFR). We compared regional CFR by dynamic SPECT and by dynamic MDCT in patients with suspected or known coronary artery disease (CAD).

Methods

Thirty-five patients, (29 males, mean age 69 years) with greater than average Framingham risk of CAD, underwent dipyridamole vasodilator stress imaging. CFR was estimated using dynamic SPECT and dynamic MDCT imaging in the same patients. Myocardial perfusion findings were correlated with obstructive CAD (≥50% luminal narrowing) on CT coronary angiography (CA).

Results

Mean CFR estimated by SPECT and MDCT in 595 myocardial segments was not different (1.51 ± 0.46 vs. 1.50 ± 0.37, p = NS). Correlation of segmental CFR by SPECT and MDCT was fair (r 2 = 0.39, p < 0.001). Bland-Altman analysis revealed that MDCT in comparison to SPECT systematically underestimated CFR in higher CFR ranges. By CTCA, 12 patients had normal CA, 11 had non-obstructive, and 12 had obstructive CAD. CFR by both techniques was significantly higher in territories of normal CA than in territories subtended by non-obstructive or obstructive CAD. SPECT CFR was also significantly different in territories subtended by non-obstructive and obstructive CAD, whereas MDCT CFR was not.

Conclusion

Despite relative underestimation of high CFR values, MDCT CFR shows promise for assessing the pathophysiological significance of anatomic CAD.

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