title: A comparison of 99mTc-MIBI myocardial SPET with electron beam computed tomography in the assessment of coronary artery disease.
abstract: We compared technetium-99m methoxyisobutylisonitrile (MIBI) myocardial perfusion single-photon emission tomography (SPET) (MPS) and electron beam computed tomography (EBCT) in order to assess their respective value in the detection of coronary artery disease (CAD). 99mTc-MIBI SPET (stress-resting) and EBCT studies were performed in 51 patients with suspected CAD who underwent coronary angiography (CAG). CAG showed that of the 51 patients, 36 had coronary stenosis >/=50% while 15 had normal results. A moderate positive rank correlation was found between coronary calcification detected by EBCT and MPS score (rs=0.5283, P<0.01). The concordance between EBCT and MPS for the evaluation of CAD was 72.5% (37/51). The sensitivity of EBCT in detecting CAD in 51 patients was comparable to that of MPS (81% vs 94%, NS). However, the accuracy of EBCT was lower than that of MPS (78% vs 94%, P<0.025). As regards the detection of individual coronary artery disease, there was no significant difference in sensitivity between EBCT and MPS (65% vs 75%, NS); however, the specificity and accuracy of EBCT were lower than those of MPS (specificity: 77% vs 95%, P<0.005; accuracy 71% vs 85%, P<0.005). The sensitivity, specificity and accuracy of MPS in detecting single-vessel disease were higher than those of EBCT (sensitivity: 86% vs 42%, P<0.025; specificity: 96% vs 70%, P<0.025; accuracy: 93% vs 61%, P<0.005). However, no significant differences in the sensitivity, specificity and accuracy of MPS and EBCT were found in respect of multivessel disease.
  
  
  CONCLUSIONS
  99mTc-MIBI myocardial perfusion SPET and EBCT provide different information in the assessment of CAD. The sensitivity of EBCT for the detection of CAD is comparable with that of MPS; however, the specificity and accuracy of EBCT are lower than those of MPS. More reliable results will be obtained if both myocardial perfusion SPET and EBCT are performed.
authors.affiliation: Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences, Peking Union of Medical College, Beijing, 100037, People's Republic of China.
authors.forename: Z
authors.initials: Z
authors.lastname: Yao
authors.forename: X J
authors.initials: XJ
authors.lastname: Liu
authors.forename: R
authors.initials: R
authors.lastname: Shi
authors.forename: R
authors.initials: R
authors.lastname: Dai
authors.forename: S
authors.initials: S
authors.lastname: Zhang
authors.forename: Y
authors.initials: Y
authors.lastname: Liu
authors.forename: S
authors.initials: S
authors.lastname: Li
authors.forename: Y
authors.initials: Y
authors.lastname: Tian
authors.forename: X
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000328:Adult; D002114:Calcinosis / Q000000981:diagnostic imaging; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi