title: Combined functional and morphological imaging consisting of gated myocardial perfusion SPECT and 16-detector multislice spiral CT angiography in the noninvasive evaluation of coronary artery disease: first experiences.
abstract: BACKGROUND
  Appropriate diagnosis and therapy of coronary artery disease (CAD) frequently require information about both the functional and morphological status of the coronary artery tree. We hypothesized that the combination of multislice spiral CT (MDCT) angiography and myocardial perfusion SPECT (MPI) provides accurate allocation of perfusion defects (PD) to their determining coronary lesion.
  
  
  METHODS
  Twenty patients (14 male, mean age 64+/-9.2 years) with known CAD were retrospectively studied. Gated MPI, CT angiography using a 16-detector CT scanner, and conventional coronary angiography (CCA) were performed in each patient. Reversible and fixed PD were subsequently allocated to their determining lesion separately by different observers for MDCT angiography and CCA.
  
  
  RESULTS
  All patients showed significant CAD in CCA; six patients with one-, six with two-, six with three-, and two with four-vessel disease; three patients had bypass grafts; and five patients had prior myocardial infarction. Correct diagnosis of CAD was stated in 14 of 20 patients by MDCT angiography. Five reversible and five fixed PD were detected in 9 of 20 patients; one patient showed both reversible and fixed PD. Five of five reversible PD could be allocated to appropriate coronary artery stenoses in CCA. In MDCT angiography, five of five reversible PD were allocated to the same lesions; all lesions were rated as >/=50%.
  
  
  CONCLUSIONS
  The preliminary results of the present study show high accuracy for multislice spiral CT angiography to allocate reversible perfusion defects in myocardial scintigraphy to their determining coronary artery lesions in a small patient collective with known coronary artery disease.
authors.affiliation: Department of Nuclear Medicine, University of Munich, Munich, Germany. marcus.hacker@med.uni-muenchen.de
authors.forename: Marcus
authors.initials: M
authors.lastname: Hacker
authors.forename: Tobias
authors.initials: T
authors.lastname: Jakobs
authors.forename: Florian
authors.initials: F
authors.lastname: Matthiesen
authors.forename: Konstantin
authors.initials: K
authors.lastname: Nikolaou
authors.forename: Christoph
authors.initials: C
authors.lastname: Becker
authors.forename: Andreas
authors.initials: A
authors.lastname: Knez
authors.forename: Reinhold
authors.initials: R
authors.lastname: Tiling
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis*; D005260:Female; D015637:Gated Blood-Pool Imaging / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D036542:Tomography, Spiral Computed / Q000379:methods*