scholarly journals The Evaluation of Left Ventricle Ischemic Extent in Patients with Significantly Suspicious Cardiovascular Disease by 99mTc-Sestamibi Dynamic SPECT/CT and Myocardial Perfusion Imaging: A Head-to-Head Comparison

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1101
Author(s):  
Hung-Pin Chan ◽  
Chin-Chuan Chang ◽  
Chin Hu ◽  
Wen-Hwa Wang ◽  
Nan-Jing Peng ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Left Ventricle ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Dynamic Spect ◽  
Artery Disease ◽  
Sensitivity Specificity ◽  
Photon Emission Computed Tomography ◽  
99Mtc Sestamibi

Heart disease is the second most common cause of mortality in Taiwan, mainly coronary artery disease (CAD).Quantitative coronary blood flow has been collected by dynamic single-photon emission computed tomography (Dynamic SPECT/CT) for CAD diagnosis in previous studies. However, few studies defined the extent of left ventricle (LV) ischemia on Dynamic SPECT/CT for predicting significant coronary artery stenosis. This study evaluates the extent of LV ischemic blockage in patients suspected of CAD who were referred by cardiologists. A total of 181 patients with suspected CAD were enrolled. They underwent 99mTc-Sestamibi (MIBI) Dynamic SPECT/CT survey before cardiac intervention. Dynamic SPECT/CT has better sensitivity (88%), specificity (96%), and accuracy (94%) compared with those of semi-quantitative MIBI MPI (more than 10%). Results indicated that5% of the LV ischemic extent can yield positive PCI results (>70% stenosis in coronary arteries) compared with the moderate abnormal extent of at least 15% of LV. When the percentage of combined moderate abnormal extent and ischemia extent of LV reaches 27.3%, positive PCI results may be indicated. This study revealed Dynamic SPECT/CT has greater sensitivity, specificity, and accuracy as compared with MPI. Thus, the severity of abnormal perfusion extent of LV on Dynamic SPECT/CT might be beneficial to predict positive PCI results in patients with significant suspicion CAD.

Coronary Flow Reserve Assessment in Patients with Cad by Dynamic Single-Photon Emission Computed Tomography

2017 ◽  
pp. 72-81
Author(s):  
A. V. Mochula ◽  
K. V. Zavadovsky ◽  
S. L. Andreev ◽  
A. L. Krylov ◽  
Yu. B. Lishmanov
Keyword(s):  
Coronary Artery ◽  
Sensitivity And Specificity ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Coronary Artery Diseases ◽  
Dynamic Spect ◽  
Flow Reserve ◽  
Artery Disease ◽  
Vessel Coronary Artery

Purpose: to assess the coronary flow reserve in patients with one,  two and multi-vessel coronary artery diseases by dynamic SPECT  using semiconductor (cadmium-zinctelluride)- based gamma camera.Material and methods.This work included 42 patients with stable  coronary artery diseases. The first group consisted of 12 (28.6%)  patients with single and two-vessel coronary artery disease (STCAD)  (8 males and 4 females; mean age 61.5 ± 3.8 years) with  intermediate (50–70%) and significant (>70%) coronary artery  stenosis. Second group included 30 (71.4%) patients with multi- vessel coronary artery diseases (MVCAD) (22 males and 8 females;  mean age 60.1 ± 4.3 years) with a lesion >70% in at least 2 major epicardial vessels according to invasive coronary angiography. All patients underwent rest-stress dynamic SPECT as well as conventional myocardial perfusion imaging with 99mTc-MIBI as a radiopharmaceutical. All scintigraphic images were  acquired on the hybrid SPECT/CT unit (GE Discovery NM/CT 570C).  Patient with STCAD underwent invasive FFR detection.Results.When comparing the results of MPI between the study  groups, there were no significant differences. ROC analysis showed  that the global MFR ≤ 1,42 allows to identify MVCAD with a  sensitivity and specificity 68% and 86,4%, for PSM, these values  are: 39.1% and 86.4% (AUC = 0.655, p < 0.05), respectively  (“gold” standard CAG). The sensitivity and specificity of the regional  MFR to identify the hemodynamic significance of coronary artery stenoses at a value of <1.33 was 100% (the “gold” standard of FFR). Most likely, high sensitivity and specificity in this case are associated with a small number of patients with true stenoses of FFR.Conclusion.The performance of standard MPI in combination with  dynamic single-photon emission computed tomography allows to  increase the diagnostic significance of the scintigraphic approach in  the evaluation of myocardial microcirculation disorders in multivessel coronary artery disease. Dynamic SPECT is a promising  method of noninvasive assessment of hemodynamic significance of  coronary artery stenoses.

scholarly journals The cost effectiveness of Single-Photon Emission-Computed Tomography compared with stress echocardiography for diagnosis of coronary artery disease

2021 ◽  
Author(s):  
Javad Javan-Noughabi ◽  
Aziz Rezapour ◽  
Marjan Hajahmadi ◽  
Vahid Alipour ◽  
Abdosaleh Jafari ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Cost Effectiveness ◽  
Coronary Artery ◽  
Stress Echocardiography ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Artery Disease ◽  
The Cost ◽  
Photon Emission Computed Tomography

Abstract Early diagnosis of coronary artery disease is very vital for success in treatment of this disease. However, the appropriate diagnostic modality for diagnosis of coronary artery disease is uncertain. Therefore, we conducted this study to compare the cost-effectiveness of Single-Photon Emission-Computed Tomography (SPECT) versus stress echocardiography for diagnosis of coronary artery disease in Iran. A decision tree model was developed to compare the cost-effectiveness of SPECT versus stress echocardiography. This study was conducted in Tehran, capital of Iran, between April 1, 2017, and September 1, 2018. The cost analysis was conducted from a societal perspective and medical direct costs, nonmedical direct costs and indirect costs were estimated. Effectiveness was defined as the accurate detection of coronary artery disease and invasive coronary angiography was used as a gold standard. The incremental cost-effectiveness ratio was defined as an additional cost per correct diagnosis. SPECT was associated with higher costs and lower effectiveness compared with stress echocardiography. Therefore, stress echocardiography is dominant alternative compared to SPECT. The results also indicated that total cost per patient were $970.49 and $781.8 for SPECT and stress echocardiography, respectively. Also, the percent of true positive and true negative responses were %88 and %79 for SPECT and %90 and %92 for stress echocardiography. The results of this study indicate that stress echocardiography is the cost-effective modality in the diagnosis of coronary artery disease compared with SPECT. According to the results, it is suggested cardiologists use stress echocardiography instead of SPECT for the diagnosis of coronary artery disease. The result of the current study has significant concepts for decision-making in designing clinical guidelines for the diagnosis of coronary artery disease.

Sign in / Sign up

Export Citation Format

Share Document