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Comparison of coronary flow reserve estimated by dynamic radionuclide SPECT and multi-detector x-ray CT

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Recent technical advances in multi-detector computed tomography (MDCT) allow for assessment of coronary flow reserve (CFR). We compared regional CFR by dynamic SPECT and by dynamic MDCT in patients with suspected or known coronary artery disease (CAD).

Methods

Thirty-five patients, (29 males, mean age 69 years) with greater than average Framingham risk of CAD, underwent dipyridamole vasodilator stress imaging. CFR was estimated using dynamic SPECT and dynamic MDCT imaging in the same patients. Myocardial perfusion findings were correlated with obstructive CAD (≥50% luminal narrowing) on CT coronary angiography (CA).

Results

Mean CFR estimated by SPECT and MDCT in 595 myocardial segments was not different (1.51 ± 0.46 vs. 1.50 ± 0.37, p = NS). Correlation of segmental CFR by SPECT and MDCT was fair (r 2 = 0.39, p < 0.001). Bland-Altman analysis revealed that MDCT in comparison to SPECT systematically underestimated CFR in higher CFR ranges. By CTCA, 12 patients had normal CA, 11 had non-obstructive, and 12 had obstructive CAD. CFR by both techniques was significantly higher in territories of normal CA than in territories subtended by non-obstructive or obstructive CAD. SPECT CFR was also significantly different in territories subtended by non-obstructive and obstructive CAD, whereas MDCT CFR was not.

Conclusion

Despite relative underestimation of high CFR values, MDCT CFR shows promise for assessing the pathophysiological significance of anatomic CAD.

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Abbreviations

CAD:

Coronary artery disease

CFR:

Coronary flow reserve

CTCA:

Computed tomography coronary angiography

MBF:

Myocardial blood flow

MDCT:

Multi-detector computed tomography

MPI:

Myocardial perfusion imaging

ROI:

Region of interest

SPECT:

Single-photon emission computed tomography

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Acknowledgements

This article was finalized under the auspices of the “Mentorship at Distance” committee of the Journal of Nuclear Cardiology. We gratefully acknowledge the editorial suggestions by Frans J. Th. Wackers, MD, PhD.

Author information

Authors and Affiliations

  1. CNR Institute of Bioimaging and Molecular Physiology, Milan, Section of Genoa, Italy

    Cecilia Marini PhD

  2. Interventional Radiology, IRCCS-AOU San Martino-IST, Genoa, Italy

    Sara Seitun MD, Margherita Castiglione Morelli MD, Irilda Budaj MD, Sara Boccalini MD, Athena Galletto Pregliasco MD & Carlo Ferro MD

  3. Clinic of Cardiovascular Diseases, IRCCS-AOU San Martino-IST, Genoa, Italy

    Camilla Zawaideh MD, Pietro Ameri PhD, Manrico Balbi MD, Claudio Brunelli MD & Gian Paolo Bezante MD

  4. Nuclear Medicine, IRCCS-AOU San Martino-IST, Genoa, Italy

    Matteo Bauckneht MD, Giulia Ferrarazzo MD, Francesco Fiz MD, Ambra Buschiazzo MD & Gianmario Sambuceti MD

  5. DITEN, University of Genoa, Genoa, Italy

    Alice Saracco MD

  6. Health Physics, IRCCS-AOU San Martino-IST, Genoa, Italy

    Maria Claudia Bagnara PhD

  7. Epidemiology Unit, IRCCS-AOU San Martino-IST, Genoa, Italy

    Paolo Bruzzi MD

Authors
  1. Cecilia Marini PhD
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  2. Sara Seitun MD
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  3. Camilla Zawaideh MD
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  4. Matteo Bauckneht MD
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  11. Sara Boccalini MD
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  17. Claudio Brunelli MD
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  18. Carlo Ferro MD
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  19. Gian Paolo Bezante MD
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  20. Gianmario Sambuceti MD
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Corresponding author

Correspondence to Matteo Bauckneht MD.

Additional information

See related editorial, doi: 10.1007/s12350-016-0528-x.

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Marini, C., Seitun, S., Zawaideh, C. et al. Comparison of coronary flow reserve estimated by dynamic radionuclide SPECT and multi-detector x-ray CT. J. Nucl. Cardiol. 24, 1712–1721 (2017). https://doi.org/10.1007/s12350-016-0492-5

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  • DOI: https://doi.org/10.1007/s12350-016-0492-5

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