Quantitation of myocardial blood flow and myocardial flow reserve with 99mTc-sestamibi dynamic SPECT/CT to enhance detection of coronary artery disease
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- 作者：Bailing Hsu (1)
Fu-Chung Chen (2)
Tao-Cheng Wu (3)
Wen-Sheng Huang (4)
Po-Nien Hou (5)
Chien-Cheng Chen (2)
Guang-Uei Hung (5) (6) (7) - 关键词：Dynamic SPECT/CT ; Myocardial blood flow quantitation ; Invasive coronary angiography ; Coronary artery disease
- 刊名：European Journal of Nuclear Medicine and Molecular Imaging
- 出版年：2014
- 出版时间：December 2014
- 年：2014
- 卷：41
- 期：12
- 页码：2294-2306
- 全文大小：4,702 KB
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14. Recio-Mayoral A, Rimoldi OE, Camici PG, Kaski JC. Inflammation and microvascular dysfunction in cardiac syndrome X patients without conventional risk factors for coronary artery disease. JACC Cardiovasc Imaging 2013;6:660-. Bailing Hsu (1)
Fu-Chung Chen (2)
Tao-Cheng Wu (3)
Wen-Sheng Huang (4)
Po-Nien Hou (5)
Chien-Cheng Chen (2)
Guang-Uei Hung (5) (6) (7)
1. Nuclear Science and Engineering Institute, University of Missouri-Columbia, Columbia, MO, USA
2. Section of Cardiology, Department of Internal Medicine, Show Chwan Memorial Hospital, Changhua, Taiwan
3. Section of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
4. Department of Medical Research & Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan
5. Department of Nuclear Medicine, Chang Bing Show Chwan Memorial Hospital, 6 Lukon Road, Lukong Town, Changhua Shien, 505, Taiwan
6. Department of Medical Imaging and Radiological Science, Central Taiwan University of Science and Technology, Taichung, Taiwan
7. Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan - ISSN：1619-7089
文摘
Purpose Conventional dual-head single photon emission computed tomography (SPECT)/CT systems capable of fast dynamic SPECT (DySPECT) imaging have a potential for flow quantitation. This study introduced a new method to quantify myocardial blood flow (MBF) and myocardial flow reserve (MFR) with DySPECT scan and evaluated the diagnostic performance of detecting coronary artery disease (CAD) compared with perfusion using invasive coronary angiography (CAG) as the reference standard. Methods This study included 21 patients with suspected or known CAD who had received DySPECT, ECG-gated SPECT (GSPECT), and CAG (13 with ?0?% stenosis in any vessel; non-CAD group: 8 with patent arteries or SPECT/CT scanner. The DySPECT imaging protocol utilized 12-min multiple back-and-forth gantry rotations during injections of 99mTc-sestamibi (MIBI) tracer at rest or dipyridamole-stress stages. DySPECT images were reconstructed with full physical corrections and converted to the physical unit of becquerels per milliliter. Stress MBF (SMBF), rest MBF (RMBF), and MFR were quantified by a one-tissue compartment flow model using time-activity curves derived from DySPECT images. Perfusion images were processed for GSPECT scan and interpreted to obtain summed stress score (SSS) and summed difference score (SDS). Receiver-operating characteristic (ROC) analyses were conducted to evaluate the diagnostic performance of flow and perfusion. Results Using the criteria of ?0?% stenosis as positive CAD, areas under the ROC curve (AUCs) of flow assessment were overall significantly greater than those of perfusion. For patient-based analysis, AUCs for MFR, SMBF, SSS, and SDS were 0.91?±-.07, 0.86?±-.09, 0.64?±-.12, and 0.59?±-.13. For vessel-based analysis, AUCs for MFR, SMBF, SSS, and SDS were 0.81?±-.05, 0.76?±-.06, 0.62?±-.07, and 0.56?±-.08, respectively. Conclusion The preliminary data suggest that MBF quantitation with a conventional SPECT/CT system and the flow quantitation method is a clinically effective approach to enhance CAD detection.