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Journal of Nuclear Cardiology
Erschienen in: Journal of Nuclear Cardiology 2/2023

15.08.2022 | Original Article

Diagnostic value of quantitative myocardial blood flow assessment by NaI(Tl) SPECT in detecting significant stenosis: a prospective, multi-center study

verfasst von: Lei Wang, MD, Yumin Zheng, MD, Jie Zhang, MD, Meng Wang, MD, Dayong Wu, MD, Yawen Wang, MD, Hong Qiu, MD, Bailing Hsu, PhD, Wei Fang, MD

Erschienen in: Journal of Nuclear Cardiology | Ausgabe 2/2023

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Abstract

Objectives

The aim of this prospective multi-center study was to investigate the diagnostic value of myocardial blood flow (MBF) quantification using NaI(Tl)-based single-photon emission computed tomography (SPECT) for determining coronary artery disease (CAD) defined by quantitative coronary angiography (QCA).

Background

Absolute quantitation of MBF and myocardial flow reserve (MFR) using SPECT is clinically feasible; however, whether flow quantification using NaI(Tl) SPECT is superior to commonly performed SPECT myocardial perfusion imaging (MPI) in determining CAD has not been evaluated.

Methods

Patients with suspected or known CAD underwent pharmacological stress/rest dynamic SPECT imaging and routine SPECT MPI followed by QCA. Obstructive disease was defined as ≥ 50% reduction in luminal diameter on QCA.

Results

One hundred fifty-four patients (462 vessels) were included in the analysis. Obstructive CAD was detected in 76/154 patients (49.4%) and 112/462 vessels (24.2%). Optimal cut-off values were 1.86 mL/min/g for stress MBF and 1.95 for MFR, respectively. Stress MBF and MFR were more sensitive than MPI in both individual patients (stress MBF vs MPI: 81.6% vs 51.3%; MFR vs MPI: 72.4% vs 51.3%) and in coronary vascular regions (stress MBF vs MPI: 78.6% vs 31.3%; MFR vs MPI: 75.9% vs 31.3%; all P < .01). In receiver operating characteristic curve analysis, quantification revealed a significantly greater area under the curve than MPI at the patient (stress MBF vs MPI: 0.761 vs 0.641; MFR vs MPI: 0.770 vs 0.641) and the vessel (stress MBF vs MPI: 0.745 vs 0.613; MFR vs MPI: 0.756 vs 0.613; all P < .05) levels. Integrating quantitative SPECT measures with MPI significantly increased the area under the curve and improved the discriminatory and reclassification capacity.

Conclusion

Flow quantification using NaI(Tl) SPECT provides superior sensitivity and discriminatory capacity to MPI in detecting significant stenosis.
Clinical trial registration NCT03637725.
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Metadaten
Titel
Diagnostic value of quantitative myocardial blood flow assessment by NaI(Tl) SPECT in detecting significant stenosis: a prospective, multi-center study
verfasst von
Lei Wang, MD
Yumin Zheng, MD
Jie Zhang, MD
Meng Wang, MD
Dayong Wu, MD
Yawen Wang, MD
Hong Qiu, MD
Bailing Hsu, PhD
Wei Fang, MD
Publikationsdatum
15.08.2022
Verlag
Springer International Publishing
Erschienen in
Journal of Nuclear Cardiology / Ausgabe 2/2023
Print ISSN: 1071-3581
Elektronische ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-022-03085-3

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