Jae Seung Seo, Presenter: Nothing to Disclose

Young Jin Kim MD, Abstract Co-Author: Nothing to Disclose

Eun Jeong Choi MD, Abstract Co-Author: Nothing to Disclose

Byoung Wook Choi MD, Abstract Co-Author: Nothing to Disclose

Kyu Ok Choe MD, Abstract Co-Author: Nothing to Disclose

To compare the coronary CT angiography with Tc-99m sestamibi SPECT in detecting significant coronary artery disease.

Forty consecutive patients with clinically suspicious significant coronary artery stenosis ( Male : 21, Female: 19, Mean age: 60.5 years ) who underwent coronary multidetector CT angiography(CTA), Tc-99m sestamibi SPECT (MIBI) and conventional coronary angiography(CCA), were enrolled from 2003 January to 2004 December. CTA with 3D/2D reconstruction using beta blocker and MIBI including rest and pharmacologic stress images were taken. The coronary arteries were assessed for the presence or absence of a significant stenosis (>50% luminal narrowing) according to the AHA coronary artery segments(all 10 segments).Two radiologists evaluated the CTA in consensus and two specialists in the nuclear medicine department evaluated MIBI imaging data. The readers were unaware of the results of the CCA. Both the results were compared with those from the CCA.

In CCA, 29 out of 40 patients had significant coronary artery stenosis; 1 vessel disease:9, 2 vessel disease :13, 3vessel disease: 7, mild coronary artery obstructive disease:6, normal coronary artery:5. CTA correctly classified 25 out of 40 patients as having at least one significant coronary stenosis (sensitivity: 92.6%, specificity:84.6%, accuracy : 90 %) and MIBI correctly classified 17 out of 40 patients (sensitivity: 62.1%, specificity:81.8%, accuracy : 67.5 %). By analyzing each coronary territory, CTA correctly classified 44 out of 56 territories as having significant coronary stenosis (LAD/RCA/LCX territories- sensitivity: 92/76.5/57.1%, specificity:86.7/95.7/92.3%, accuracy: 90 /87.5/ 80 %, respectively) and MIBI correctly classified 28 out of 56 territories(LAD/RCA/LCX territories- sensitivity: 40/82.4/28.6%, specificity:86.7/91.3/100%, accuracy : 57.5 /87.5/ 75 %, respectively). CTA detected an addition of eight more significant stenosis to MIBI results.

Compared to MIBI, CTA showed better localization of significant stenotic site and relatively higher accuracy. CTA is first recommended as a noninvasive examination in detecting significant coronary artery stenosis.

Seo, J, Kim, Y, Choi, E, Choi, B, Choe, K, Comparison of Coronary CT Angiography and Tc-99m Sestamibi SPECT in Detecting Significant Coronary Artery Stenosis.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4415607.html