Gopi Kiran Reddy Sirineni MD, Presenter: Nothing to Disclose

Cesar Santana MD, Abstract Co-Author: Nothing to Disclose

Luidmila Verdes MD, Abstract Co-Author: Nothing to Disclose

Favio Esteves, Abstract Co-Author: Nothing to Disclose

Tracy Faber, Abstract Co-Author: Nothing to Disclose

Minu Bawa, Abstract Co-Author: Nothing to Disclose

Arthur Elton Stillman MD, PhD, Abstract Co-Author: Nothing to Disclose

Ernest Garcia PhD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Catheter angiogram (Cath) is the gold standard at present in the assessment of Coronary artery disease (CAD). Our study evaluates the performance of myocardial perfusion imaging (MPI) and MDCT Coronary angiography (CTA) in the assessment of CAD.

Thirty-nine patients (12 female, mean age 57±11years) who had MPI and CTA with in an interval of one month were enrolled for the study. MPI was performed SPECT TC-99m Sestamibi (n=10), SPECT TC-99m Tetrosofosmin (n=19) and by Rb-82 PET/CT (n=10). CTA was performed using either 64 Slice MDCT (n=20) or 16 slice (n=19). Twenty seven patients had high likelihood of CAD and underwent Cath. CTA and MPI interpretations were done blinded to each other and to the Cath results. The results of clinical of each modality were compared on a global and per vessel basis for the presence of CAD.

Both MPI and CTA showed similar performance in a population with low likelihood of CAD (n=11, normalcy rate: 10/12=91%). Twenty three of the 27 patients who underwent cath had CAD (stenosis > 50%). In the high risk group, however CTA showed marginal higher accuracy than MPI on the overall assessment of CAD (CTA sensitivity: 22/23 =96% vs. MPI: 21/23=91%. CTA specificity: 4/4:100% vs. MPI: 3/4: 75%. The individual vessel analysis shows a trend of higher sensitivity for CTA (CTA sensitivity: 39/45=87% vs. MPI: 32/45=71%) with higher specificity for MPI (CTA specificity: 30/36=83% vs. MPI: 32/36=89%. Any of the differences were statistically significant (P>0.05)

MPI and CTA show high accuracy in the diagnosis of CAD. Our findings suggest that the association of both techniques may improve non-invasive assessment of CAD per individual vessel analysis, however further studies have to be performed to know if the combination of CTA and MPI has incremental value over each others independently.

CTA and MPI can be used in combination to assess CAD and can get similar results to Cath, non invasively.

Sirineni, G, Santana, C, Verdes, L, Esteves, F, Faber, T, Bawa, M, Stillman, A, Garcia, E, et al, , Assessment of Coronary Artery Disease: Comparison of Performance of Myocardial Perfusion Imaging and MDCT Coronary Angiography with Catheter Angiogram.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4441956.html