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Ischemic burden assessment of myocardial perfusion CT, compared with SPECT using semi-quantitative and quantitative approaches

Ischemic burden assessment of myocardial perfusion CT, compared with SPECT using semi-quantitative and quantitative approaches

Authors :
Hye Jeon Hwang
Young-Hak Kim
Hyun Jung Koo
Joon-Won Kang
Jeong A Kim
Hee Jun Kang
Osung Kwon
Dong Hyun Yang
Hyun-Sook Kim
Dae Hyuk Moon
Source :
International Journal of Cardiology. 278:287-294
Publication Year :
2019
Publisher :
Elsevier BV, 2019.

Abstract

Background We aimed to compare the myocardial ischemic burden assessed using semi-quantitative and quantitative analysis of computed tomography-myocardial perfusion imaging (CT-MPI) with that of single-photon emission computed tomography (SPECT). Methods From 2011 to 2013, 97 patients who underwent CT-MPI and SPECT were evaluated. The extent and severity of perfusion defects were assessed on a 5-point scale using a standard 16-segment model, and were expressed as summed stress score (SSS) and summed difference score (SDS). Receiver operating characteristic (ROC) curves for quantitative parameters were generated for the diagnosis of abnormal perfusion defect (SSS ≥ 4) and presence of ischemia (SDS ≥ 2) on SPECT. Results On CT-MPI, 298 (19.2%) of the 1552 segments showed perfusion abnormalities during stress, whereas perfusion abnormalities were shown in 179 (11.5%) segments on SPECT-MPI. On a per-person basis, there was good agreement, with intraclass correlation coefficients of 0.78 for SSS and 0.72 for SDS. A significant reduction of attenuation in stress and myocardial perfusion reserve index, along with an increase in % defect volume of CT-MPI, were demonstrated as the degree of perfusion defect or ischemia on SPECT increased. On the ROC curves, % defect volume on CT-MPI demonstrated the highest area under the curve: 0.91 for abnormal perfusion defect and 0.89 (all p Conclusions Semi-quantitative analysis of CT-MPI showed good accordance with SPECT. A quantitative approach for CT-MPI, especially % defect volume, may provide additional value in the identification of myocardial perfusion abnormalities. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT01696006 .

Details

ISSN :
01675273
Volume :
278
Database :
OpenAIRE
Journal :
International Journal of Cardiology
Accession number :
edsair.doi.dedup.....4987719a74023901b605dc8e7f08f05c
Full Text :
https://doi.org/10.1016/j.ijcard.2018.12.046