title: A comparison of 99Tcm-MIBI myocardial SPET and electron beam computed tomography in the assessment of coronary artery disease in two different age groups.
abstract: The aim of this study was to compare the clinical value of 99Tcm-MIBI single photon emission tomography (SPET) and electron beam computed tomography (EBCT) in the assessment of coronary artery disease (CAD) in different age groups. 99Tcm-MIBI SPET (stress-rest), EBCT and coronary angiography studies were performed in 64 consecutive patients with suspected CAD. The patients were classified into two groups: Group A = 40 patients > 45 years of age and Group B = 24 patients < or = 45 years of age. There were 31 and 14 patients with coronary stenosis > or = 50% as determined by coronary angiography in Groups A and B, respectively. All patients (30 cases) with abnormal 99Tcm-MIBI myocardial SPET and coronary calcification detected by EBCT had significant coronary artery disease, and 93.3% of the patients with normal 99Tcm-MIBI SPET and normal EBCT had normal coronary angiography or < 50% lumen narrowing of the coronary arteries. In Group B, the sensitivity of SPET for detecting CAD was significantly higher than that of EBCT (92.9 vs 42.9%, P < 0.01); the specificity of SPET was comparable to that of EBCT. In Group A, there was no significant difference between SPET and EBCT in terms of sensitivity (93.6 vs 90.3%) or specificity (88.9 vs 55.6%). However, in the detection of individual coronary artery disease, the specificity of SPET was significantly higher than that of EBCT in Group A (94.1 vs 66.7%, P < 0.001). The sensitivity of SPET was again significantly higher than that of EBCT (85.7 vs 38.1%, P < 0.005) in Group B. The accuracy of SPET was higher than that of EBCT in both groups (82.5 vs 67.5%, P < 0.01 in Group A; 93.1 vs 76.4%, P < 0.01 in Group B, respectively). We conclude that 99Tcm-MIBI myocardial perfusion SPET has a higher sensitivity than EBCT in the detection of CAD in patients < or = 45 years old and a higher specificity in patients > 45 years of age. A combination of SPET and EBCT may assess CAD more accurately.
authors.affiliation: Department of Nuclear Medicine, Fu Wai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 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 F
authors.initials: RF
authors.lastname: Shi
authors.forename: R
authors.initials: R
authors.lastname: Dai
authors.forename: S
authors.initials: S
authors.lastname: Zhang
authors.forename: Y Z
authors.initials: YZ
authors.lastname: Liu
authors.forename: Y Q
authors.initials: YQ
authors.lastname: Tian
authors.forename: X L
authors.initials: XL
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000367:Age Factors; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi