Study Supports Protocol for Cardiac Computed Tomography

CT stress myocardial perfusion imaging compared well against SPECT in finding stenosis

09 sept 2009-- Adenosine stress computed tomography (CT) may have similar accuracy in discovering stress-induced myocardial perfusion defects as single-photon emission computed tomography (SPECT), according to research published in the Sept. 15 issue of the Journal of the American College of Cardiology.

Ron Blankstein, M.D., of the Massachusetts General Hospital and Harvard Medical School in Boston, and colleagues analyzed data from 34 patients who underwent invasive angiography and a nuclear stress test. Dual-source computed tomography (DSCT) involved stress CT with adenosine, rest CT, and a delayed scan.

On a per-vessel basis, the researchers found that CT perfusion had a sensitivity of 79 percent and a specificity of 80 percent for detecting stenosis of at least 50 percent on invasive angiography, compared to 67 and 83 percent, respectively, for SPECT myocardial perfusion imaging. CT angiography during adenosine had a per-vessel sensitivity of 96 percent and a specificity of 73 percent for detecting stenosis of at least 70 percent.

"In one of the first human studies of adenosine-mediated stress DSCT, we showed the feasibility of a novel cardiac CT protocol that combines stress and rest myocardial perfusion imaging together with coronary computed tomography angiography in a single examination. Furthermore, we showed that CT stress myocardial perfusion imaging has comparable diagnostic accuracy to SPECT in detecting hemodynamically significant stenosis. Importantly, in this comprehensive CT protocol information on coronary anatomy, stress perfusion, rest perfusion, function, and delayed enhancement was available with an average radiation exposure that was equivalent to SPECT," the authors write.

The study was supported by Astellas Inc., and several co-authors reported financial relationships with Astellas or other companies.

Abstract
Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)