Hybrid CT angiography and quantitative 15O-water PET for assessment of coronary artery disease: comparison with quantitative coronary angiography View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2013-12

AUTHORS

Anders Thomassen, Henrik Petersen, Axel C. P. Diederichsen, Hans Mickley, Lisette O. Jensen, Allan Johansen, Oke Gerke, Poul-Erik Braad, Per Thayssen, Mette M. Høilund-Carlsen, Werner Vach, Juhani Knuuti, Poul F. Høilund-Carlsen

ABSTRACT

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 (15)O-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. More... »

PAGES

1894-1904

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00259-013-2519-3

DOI

http://dx.doi.org/10.1007/s00259-013-2519-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1047467265

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23982453


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