title: Diagnostic accuracy of quantitative cardiac MRI evaluation compared to stress single-photon-emission computed tomography.
abstract: BACKGROUND
  Cardiac MRI (cMRI) perfusion is a promising non-invasive tool to assess myocardial ischemia. The accuracy of quantitative cMRI perfusion has been recently demonstrated, but to date no previous study has compared this technique with stress single-photon-emission computed tomography (SPECT). The aim of this study was to evaluate the diagnostic accuracy of myocardial perfusion reserve (MPR) based on cMRI compared with SPECT.
  
  
  METHODS
  We examined 24 patients who underwent coronary angiography, stress SPECT and cMRI perfusion. Qualitative assessment of both SPECT and cMRI images, quantification of cMRI perfusion, and quantitative coronary angiography (QCA) were independently performed. MPR was calculated using Fermi deconvolution technique. Accuracy of quantitative and qualitative data was examined to detect > 50% diameter stenosis (DS) by QCA.
  
  
  RESULTS
  Qualitative analysis was obtained in 198 segments and quantitative analysis was performed in 171 segments. Significant coronary artery disease (CAD) was present in 81.8% of patients. Visual cMRI assessment yielded sensitivity of 74.4% and specificity of 79.4% to predict > 50%DS, while SPECT showed sensitivity of 67.4% and specificity of 81.3%. The sensitivity for SPECT in the right coronary artery territory and apex was low compared to cMRI. Sensitivity and specificity for detection of significant CAD were 89.5% and 46.6% for MPR (cutoff 1.92). Area under the curve was 0.75 for MPR (P < 0.01).
  
  
  CONCLUSIONS
  The diagnostic accuracy of qualitative examination of perfusion cardiac MRI and stress SPECT were comparable. The high sensitivity and low operator dependency of quantitative cMRI makes it an attractive tool to evaluate myocardial perfusion.
authors.affiliation: Division of Cardiology and Cardiovascular Imaging Core Laboratories, University of Florida, 655 West 8th Street, Jacksonville, FL 32209, USA.
authors.forename: Hideki
authors.initials: H
authors.lastname: Futamatsu
authors.forename: Chris
authors.initials: C
authors.lastname: Klassen
authors.forename: Marco
authors.initials: M
authors.lastname: Pilla
authors.forename: Norbert
authors.initials: N
authors.lastname: Wilke
authors.forename: Dominick J
authors.initials: DJ
authors.lastname: Angiolillo
authors.forename: Stuart
authors.initials: S
authors.lastname: Smalheiser
authors.forename: Alan
authors.initials: A
authors.lastname: Siuciak
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Suzuki
authors.forename: Theodore A
authors.initials: TA
authors.lastname: Bass
authors.forename: Marco A
authors.initials: MA
authors.lastname: Costa
mesh_terms: D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*