Hybrid CT angiography and quantitative 15O-water PET for assessment of coronary artery disease: comparison with quantitative coronary angiography
| Autor: | Lisette Okkels Jensen, Poul Flemming Høilund-Carlsen, Mette Høilund-Carlsen, Oke Gerke, Werner Vach, Poul-Erik Braad, Anders Thomassen, Allan Johansen, Axel Cosmus Pyndt Diederichsen, Hans Mickley, Per Thayssen, Juhani Knuuti, Henrik Petersen |
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| Rok vydání: | 2013 |
| Předmět: |
Coronary angiography
Adult Male medicine.medical_specialty PET/CT Hemodynamics Diagnostic accuracy Coronary Artery Disease Coronary Angiography Myocardial blood flow Multimodal Imaging Coronary artery disease Oxygen Radioisotopes Quantification Coronary Circulation Medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Aged Aged 80 and over PET-CT medicine.diagnostic_test business.industry musculoskeletal neural and ocular physiology Water General Medicine Blood flow Middle Aged medicine.disease O-Water medicine.anatomical_structure Hybrid imaging Positron-Emission Tomography Angiography Female Radiology business Tomography X-Ray Computed psychological phenomena and processes Artery |
| Zdroj: | Thomassen, A, Petersen, H, Diederichsen, A C P, Mickley, H, Jensen, L O, Johansen, A, Gerke, O, Braad, P-E, Thayssen, P, Høilund-Carlsen, M M, Vach, W, Knuuti, J & Høilund-Carlsen, P F 2013, ' Hybrid CT angiography and quantitative (15)O-water PET for assessment of coronary artery disease : comparison with quantitative coronary angiography ', European Journal of Nuclear Medicine and Molecular Imaging, vol. 40, no. 12, pp. 1894-1904 . https://doi.org/10.1007/s00259-013-2519-3 |
| ISSN: | 1619-7089 |
| DOI: | 10.1007/s00259-013-2519-3 |
| Popis: | Purpose: CT angiography (CTA) can rule out significant stenoses with a very high reliability, whereas its ability to confirm significant stenoses is suboptimal. In contrast, measurements of myocardial blood flow (MBF) provide information on the haemodynamic consequences of stenoses. Therefore, a combination of the two might improve diagnostic accuracy. We conducted a head-to-head comparison of CTA, measurement of MBF by 15O-water PET, and hybrid PET/CTA for the detection of significant coronary artery stenoses. Methods: The study group comprised 44 outpatients scheduled for invasive coronary angiography (ICA) with an intermediate pretest likelihood of coronary artery disease. The patients underwent 64-slice CTA and baseline and hyperaemic PET before ICA with quantitative coronary angiography analysis. Results: On a per-patient basis, the negative predictive values (NPV; 95 % confidence intervals in parentheses) were 88 % (64 - 97 %) for CTA, 90 % (71 - 97%) for PET and 92 % (74 - 98%) for PET/CTA, and the positive predictive values (PPV) were 71 % (53 - 85%) for CTA, 87 % (68 - 95%) for PET and 100 % (84 - 100%) for PET/CTA. Similarly, on a per-vessel basis the NPVs (which were generally high) were 97 % (94 - 100%) for CTA, 95 % (90 - 99%) for PET and 97 % (95 - 100%) for PET/CTA, and the PPVs (which were lower, but higher with PET/CTA) were 53 % (39 - 66%) for CTA, 53 % (40 - 66%) for PET and 85 % (73 - 97%) for PET/CTA. In six patients, CTA analysis was hampered by the presence of severe calcifications. However, with the addition of the PET data, all six patients were correctly categorized. Conclusion: Cardiac quantitative hybrid PET/CTA imaging has better diagnostic accuracy than CTA alone and PET alone. CTA has a suboptimal PPV, suggesting that hybrid PET/CTA imaging should be used to assess the significance of coronary stenoses diagnosed by CTA. |
| Databáze: | OpenAIRE |
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