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European Radiology

, Volume 25, Issue 7, pp 2115–2124 | Cite as

Patient satisfaction with coronary CT angiography, myocardial CT perfusion, myocardial perfusion MRI, SPECT myocardial perfusion imaging and conventional coronary angiography

  • S. Feger
  • M. Rief
  • E. Zimmermann
  • F. Richter
  • R. Roehle
  • M. Dewey
  • E. Schönenberger
Cardiac

Abstract

Objectives

To evaluate patient acceptance of noninvasive imaging tests for detection of coronary artery disease (CAD), including single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI), stress perfusion magnetic resonance imaging (MRI), coronary CT angiography (CTA) in combination with CT myocardial stress perfusion (CTP), and conventional coronary angiography (CCA).

Methods

Intraindividual comparison of perception of 48 patients from the CORE320 multicentre multinational study who underwent rest and stress SPECT-MPI with a technetium-based tracer, combined CTA and CTP (both with contrast agent, CTP with adenosine), MRI, and CCA. The analysis was performed by using a validated questionnaire.

Results

Patients had significantly more concern prior to CCA than before CTA/CTP (p < 0.001). CTA/CTP was also rated as more comfortable than SPECT-MPI (p = 0.001). Overall satisfaction with CT was superior to that of MRI (p = 0.007). More patients preferred CT (46 %; p < 0.001) as a future diagnostic test. Regarding combined CTA/CTP, CTP was characterised by higher pain levels and an increased frequency of angina pectoris during the examination (p < 0.001). Subgroup analysis showed a higher degree of pain during SPECT-MPI with adenosine stress compared to physical exercise (p = 0.016).

Conclusions

All noninvasive cardiac imaging tests are well accepted by patients, with CT being the preferred examination.

Key Points

A variety of cardiac imaging tests is available without known patient preference

CTA/CTP shows a lower degree of concern than conventional coronary angiography

CTA/CTP shows higher overall satisfaction compared to stress perfusion magnetic resonance imaging

CTA/CTP is rated as more comfortable than SPECT-MPI

CTA/CTP is the preferred cardiac imaging test

Keywords

Coronary artery disease Multidetector computed tomography Single-photon emission computed tomography Stress perfusion magnetic resonance imaging Patient satisfaction 

Abbreviations

bpm

Beats per minute

CAD

Coronary artery disease

CCA

Conventional coronary angiography

MRI

Stress perfusion magnetic resonance imaging

CTA

Coronary computed tomography angiography

CTP

Computed tomography myocardial stress perfusion

FFR

Fractional flow reserve

IV

Intravenous

PCI

Percutaneous coronary intervention

SPECT-MPI

Single-photon emission computed tomography myocardial perfusion imaging

VAS

Visual analog scale

Notes

Acknowledgements

The scientific guarantor of this publication is Professor Marc Dewey. The authors of this manuscript declare relationships with the following companies: Prof. Dewey has received grant support from the Heisenberg Program of the DFG for a professorship (DE 1361/14-1), the FP7 Program of the European Commission for the randomized multicenter DISCHARGE trial (603266-2, HEALTH-2012.2.4.-2), the European Regional Development Fund (20072013 2/05, 20072013 2/48), the German Heart Foundation/German Foundation of Heart Research (F/23/08, F/27/10), the Joint Program from the German Research Foundation (DFG) and the German Federal Ministry of Education and Research (BMBF) for meta-analyses (01KG1013, 01KG1110, 01KG1110), GE Healthcare, Bracco, Guerbet, and Toshiba Medical Systems.

Prof. Dewey has received lecture fees from Toshiba Medical Systems, Guerbet, Cardiac MR Academy Berlin, and Bayer (Schering-Berlex).

Prof. Dewey is a consultant to Guerbet and one of the principal investigators of multi-center studies (CORE-64 and 320) on coronary CT angiography sponsored by Toshiba Medical Systems. He is also the editor of Coronary CT Angiography and Cardiac CT, both published by Springer, and offers hands-on workshops on cardiovascular imaging (www.ct-kurs.de). Prof. Dewey is an associate editor of Radiology and European Radiology.

Institutional master research agreements exist with Siemens Medical Solutions, Philips Medical Systems, and Toshiba Medical Systems. The terms of these arrangements are managed by the legal department of Charité – Universitätsmedizin Berlin. The CORE-320 study has received funding from Toshiba Medical Systems. Two of the authors (FR, RR) have significant statistical expertise. Institutional review board approval was obtained. Written informed consent was obtained from all patients in this study.

The study subjects or cohorts have not been previously reported in regards to patient acceptance. The CORE-320 main study publication in regards to diagnostic accuracy has been published recently be Rochitte et al. (Eur Heart J 2014) and this is a single-centre substudy on the intraindividual patient perception of four cardiac imaging tests. Methodology: prospective, non-randomised controlled trial / intraindividual comparison, performed at one institution.

Supplementary material

330_2015_3604_MOESM1_ESM.docx (42 kb)
ESM 1 (DOCX 41 kb)

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Copyright information

© European Society of Radiology 2015

Authors and Affiliations

  • S. Feger
    • 1
  • M. Rief
    • 1
  • E. Zimmermann
    • 1
  • F. Richter
    • 1
  • R. Roehle
    • 1
  • M. Dewey
    • 1
    • 3
  • E. Schönenberger
    • 2
  1. 1.Department of Radiology, Charité - Universitätsmedizin Berlin Campus Mitte, Humboldt-Universität zu BerlinFreie Universität BerlinBerlinGermany
  2. 2.Department of MedicineMedizinische Hochschule HannoverHannoverGermany
  3. 3.Institut für RadiologieBerlinGermany

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