Integrated Single-Photon Emission Computed Tomography and Computed Tomography Coronary Angiography for the Assessment of Hemodynamically Significant Coronary Artery Lesions

Shmuel Rispler, Zohar Keidar, Eduard Ghersin, Ariel Roguin, Adrian Soil, Robert Dragu, Diana Litmanovich, Alex Frenkel, Doron Aronson, Ahuva Engel, Rafael Beyar, Ora Israel

Research output: Contribution to journalArticle

Abstract

Objectives: The purpose of this study was to assess the physiologic significance of coronary artery lesions with an integrated single-photon emission computed tomography (SPECT) and computed tomography coronary angiography (CTCA) device. Background: Myocardial perfusion imaging (MPI) with SPECT is of value for assessing the physiologic significance of coronary lesions. Computed tomography coronary angiography is a new technique to noninvasively detect coronary stenosis, with high sensitivity and negative predictive value (NPV) but lower specificity and positive predictive value (PPV). The experimental SPECT/CTCA hybrid imaging device (Infinia gamma camera and LightSpeed16 CT, General Electric, Milwaukee, Wisconsin) enables concurrent assessment of coronary anatomy and myocardial perfusion. Methods: Fifty-six patients with angina pectoris underwent single-session SPECT-MPI and CTCA with the hybrid device and coronary angiography (CA) within 4 weeks. The ability of fused SPECT/CTCA images to diagnose physiologically significant lesions showing >50% stenosis and reversible perfusion defects in the same territory was determined and compared with CTCA stand-alone. Results: Of a total of 224 coronary segments in 56 patients, 12 patients and 54 segments (23%) were excluded from further analysis of CTCA. Overall, 170 coronary segments were evaluated. The sensitivity, specificity, PPV, and NPV of CTCA were 96%, 63%, 31%, and 99%, respectively, as compared with 96%, 95%, 77%, and 99%, respectively, for SPECT/CTCA. Conclusions: Hybrid SPECT/CTCA imaging results in improved specificity and PPV to detect hemodynamically significant coronary lesions in patients with chest pain. Single-photon emission computed tomography/CTCA might play a potentially important role in the noninvasive diagnosis of coronary artery disease and introduce an objective decision-making tool for assessing the need for interventions in each occluded vessel.

Original languageEnglish (US)
Pages (from-to)1059-1067
Number of pages9
JournalJournal of the American College of Cardiology
Volume49
Issue number10
DOIs
StatePublished - Mar 13 2007
Externally publishedYes

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Coronary Angiography
Coronary Vessels
Myocardial Perfusion Imaging
Single-Photon Emission-Computed Tomography
Equipment and Supplies
Single Photon Emission Computed Tomography Computed Tomography
Computed Tomography Angiography
Perfusion
Multimodal Imaging
Gamma Cameras
Aptitude
Coronary Stenosis
Angina Pectoris
Chest Pain
Coronary Artery Disease
Anatomy
Decision Making
Pathologic Constriction
Sensitivity and Specificity

ASJC Scopus subject areas

  • Nursing(all)

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Integrated Single-Photon Emission Computed Tomography and Computed Tomography Coronary Angiography for the Assessment of Hemodynamically Significant Coronary Artery Lesions. / Rispler, Shmuel; Keidar, Zohar; Ghersin, Eduard; Roguin, Ariel; Soil, Adrian; Dragu, Robert; Litmanovich, Diana; Frenkel, Alex; Aronson, Doron; Engel, Ahuva; Beyar, Rafael; Israel, Ora.

In: Journal of the American College of Cardiology, Vol. 49, No. 10, 13.03.2007, p. 1059-1067.

Research output: Contribution to journalArticle

Rispler, S, Keidar, Z, Ghersin, E, Roguin, A, Soil, A, Dragu, R, Litmanovich, D, Frenkel, A, Aronson, D, Engel, A, Beyar, R & Israel, O 2007, 'Integrated Single-Photon Emission Computed Tomography and Computed Tomography Coronary Angiography for the Assessment of Hemodynamically Significant Coronary Artery Lesions', Journal of the American College of Cardiology, vol. 49, no. 10, pp. 1059-1067. https://doi.org/10.1016/j.jacc.2006.10.069
Rispler, Shmuel ; Keidar, Zohar ; Ghersin, Eduard ; Roguin, Ariel ; Soil, Adrian ; Dragu, Robert ; Litmanovich, Diana ; Frenkel, Alex ; Aronson, Doron ; Engel, Ahuva ; Beyar, Rafael ; Israel, Ora. / Integrated Single-Photon Emission Computed Tomography and Computed Tomography Coronary Angiography for the Assessment of Hemodynamically Significant Coronary Artery Lesions. In: Journal of the American College of Cardiology. 2007 ; Vol. 49, No. 10. pp. 1059-1067.
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abstract = "Objectives: The purpose of this study was to assess the physiologic significance of coronary artery lesions with an integrated single-photon emission computed tomography (SPECT) and computed tomography coronary angiography (CTCA) device. Background: Myocardial perfusion imaging (MPI) with SPECT is of value for assessing the physiologic significance of coronary lesions. Computed tomography coronary angiography is a new technique to noninvasively detect coronary stenosis, with high sensitivity and negative predictive value (NPV) but lower specificity and positive predictive value (PPV). The experimental SPECT/CTCA hybrid imaging device (Infinia gamma camera and LightSpeed16 CT, General Electric, Milwaukee, Wisconsin) enables concurrent assessment of coronary anatomy and myocardial perfusion. Methods: Fifty-six patients with angina pectoris underwent single-session SPECT-MPI and CTCA with the hybrid device and coronary angiography (CA) within 4 weeks. The ability of fused SPECT/CTCA images to diagnose physiologically significant lesions showing >50{\%} stenosis and reversible perfusion defects in the same territory was determined and compared with CTCA stand-alone. Results: Of a total of 224 coronary segments in 56 patients, 12 patients and 54 segments (23{\%}) were excluded from further analysis of CTCA. Overall, 170 coronary segments were evaluated. The sensitivity, specificity, PPV, and NPV of CTCA were 96{\%}, 63{\%}, 31{\%}, and 99{\%}, respectively, as compared with 96{\%}, 95{\%}, 77{\%}, and 99{\%}, respectively, for SPECT/CTCA. Conclusions: Hybrid SPECT/CTCA imaging results in improved specificity and PPV to detect hemodynamically significant coronary lesions in patients with chest pain. Single-photon emission computed tomography/CTCA might play a potentially important role in the noninvasive diagnosis of coronary artery disease and introduce an objective decision-making tool for assessing the need for interventions in each occluded vessel.",
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T1 - Integrated Single-Photon Emission Computed Tomography and Computed Tomography Coronary Angiography for the Assessment of Hemodynamically Significant Coronary Artery Lesions

AU - Rispler, Shmuel

AU - Keidar, Zohar

AU - Ghersin, Eduard

AU - Roguin, Ariel

AU - Soil, Adrian

AU - Dragu, Robert

AU - Litmanovich, Diana

AU - Frenkel, Alex

AU - Aronson, Doron

AU - Engel, Ahuva

AU - Beyar, Rafael

AU - Israel, Ora

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N2 - Objectives: The purpose of this study was to assess the physiologic significance of coronary artery lesions with an integrated single-photon emission computed tomography (SPECT) and computed tomography coronary angiography (CTCA) device. Background: Myocardial perfusion imaging (MPI) with SPECT is of value for assessing the physiologic significance of coronary lesions. Computed tomography coronary angiography is a new technique to noninvasively detect coronary stenosis, with high sensitivity and negative predictive value (NPV) but lower specificity and positive predictive value (PPV). The experimental SPECT/CTCA hybrid imaging device (Infinia gamma camera and LightSpeed16 CT, General Electric, Milwaukee, Wisconsin) enables concurrent assessment of coronary anatomy and myocardial perfusion. Methods: Fifty-six patients with angina pectoris underwent single-session SPECT-MPI and CTCA with the hybrid device and coronary angiography (CA) within 4 weeks. The ability of fused SPECT/CTCA images to diagnose physiologically significant lesions showing >50% stenosis and reversible perfusion defects in the same territory was determined and compared with CTCA stand-alone. Results: Of a total of 224 coronary segments in 56 patients, 12 patients and 54 segments (23%) were excluded from further analysis of CTCA. Overall, 170 coronary segments were evaluated. The sensitivity, specificity, PPV, and NPV of CTCA were 96%, 63%, 31%, and 99%, respectively, as compared with 96%, 95%, 77%, and 99%, respectively, for SPECT/CTCA. Conclusions: Hybrid SPECT/CTCA imaging results in improved specificity and PPV to detect hemodynamically significant coronary lesions in patients with chest pain. Single-photon emission computed tomography/CTCA might play a potentially important role in the noninvasive diagnosis of coronary artery disease and introduce an objective decision-making tool for assessing the need for interventions in each occluded vessel.

AB - Objectives: The purpose of this study was to assess the physiologic significance of coronary artery lesions with an integrated single-photon emission computed tomography (SPECT) and computed tomography coronary angiography (CTCA) device. Background: Myocardial perfusion imaging (MPI) with SPECT is of value for assessing the physiologic significance of coronary lesions. Computed tomography coronary angiography is a new technique to noninvasively detect coronary stenosis, with high sensitivity and negative predictive value (NPV) but lower specificity and positive predictive value (PPV). The experimental SPECT/CTCA hybrid imaging device (Infinia gamma camera and LightSpeed16 CT, General Electric, Milwaukee, Wisconsin) enables concurrent assessment of coronary anatomy and myocardial perfusion. Methods: Fifty-six patients with angina pectoris underwent single-session SPECT-MPI and CTCA with the hybrid device and coronary angiography (CA) within 4 weeks. The ability of fused SPECT/CTCA images to diagnose physiologically significant lesions showing >50% stenosis and reversible perfusion defects in the same territory was determined and compared with CTCA stand-alone. Results: Of a total of 224 coronary segments in 56 patients, 12 patients and 54 segments (23%) were excluded from further analysis of CTCA. Overall, 170 coronary segments were evaluated. The sensitivity, specificity, PPV, and NPV of CTCA were 96%, 63%, 31%, and 99%, respectively, as compared with 96%, 95%, 77%, and 99%, respectively, for SPECT/CTCA. Conclusions: Hybrid SPECT/CTCA imaging results in improved specificity and PPV to detect hemodynamically significant coronary lesions in patients with chest pain. Single-photon emission computed tomography/CTCA might play a potentially important role in the noninvasive diagnosis of coronary artery disease and introduce an objective decision-making tool for assessing the need for interventions in each occluded vessel.

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