Comparison of computed tomographic angiography versus rubidium-82 positron emission tomography for the detection of patients with anatomical coronary artery disease.
BACKGROUND
The present study compared computed tomographic coronary angiography (CTA) and positron emission tomography (PET) for the detection of significant anatomical coronary artery stenosis as defined by conventional invasive coronary angiography (CICA).


METHODS
The study protocol was approved by the local ethics board, and informed consent was obtained from all patients. Of the 26 patients (mean age 57+/-9 years, 18 men) who prospectively underwent CTA and rubidium-82 PET before CICA, 24 patients had a history of chest pain. Images were interpreted by expert readers and assessed for the presence of anatomically significant coronary stenosis (50% luminal diameter stenosis or greater) or myocardial perfusion defects. Diagnostic test characteristics were analyzed using patient-based, territory-based, vessel-based and segment-based analyses.


RESULTS
In the 24 patients referred for chest pain, CTA had similar sensitivity to PET, but was more specific (sensitivity 95% [95% CI 72% to 100%] versus 95% [95% CI 72% to 100%], respectively; specificity 100% [95% CI 46% to 100%] versus 60% [95% CI 17% to 93%], respectively) in the detection of patients with anatomical coronary artery stenosis of 50% or greater. On a per-segment basis of all 26 patients, CTA had a sensitivity, specificity, positive predictive value and negative predictive value of 72%, 99%, 91% and 95%, respectively, in all coronary segments.


CONCLUSIONS
Coronary CTA has a similar sensitivity and specificity to rubidium-82 PET for the identification of patients with significant anatomical coronary artery disease.
Chow
Benjamin J W
BJ
Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada. bchow@ottawaheart.ca
Dennie
Carole
C
Hoffmann
Udo
U
So
Derek
D
de Kemp
Robert A
RA
Ruddy
Terrence D
TD
Beanlands
Rob S
RS
D002637:Chest Pain / Q000175:diagnosis; D017023:Coronary Angiography / Q000295:instrumentation / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D023921:Coronary Stenosis / Q000175:diagnosis / Q000000981:diagnostic imaging; D003331:Coronary Vessels / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D012414:Rubidium Radioisotopes; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D012414:Rubidium Radioisotopes
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