title: Diagnostic accuracy of myocardial perfusion imaging with single photon emission computed tomography and positron emission tomography: a comparison with coronary angiography.
abstract: OBJECTIVE
  The aim of this study was to compare the diagnostic accuracy of myocardial perfusion imaging (MPI) by positron emission tomography (PET) with the diagnostic accuracy of MPI by single photon emission computed tomography (SPECT) in two comparable patient cohorts, using coronary angiography (CA) as the standard of reference.
  
  
  METHODS
  A "SPECT-group" of 80 patients (15 female, 65 male; mean age 60+/-9 years) and a "PET-group" of 70 patients (14 female, 56 male; mean age 57+/-10 years) underwent a one day stress/rest examination either with attenuation-corrected (13)N-ammonia PET or attenuation-corrected (201)TlCl SPECT or (99m)Tc-hexakis-methoxy-isobutyl-isonitril (MIBI) SPECT. PET and SPECT results were semiquantitatively graded using a 6-segment heart model. All patients underwent CA, and stenoses were graded as a diameter reduction >or=50%.
  
  
  RESULTS
  Coronary findings between both groups did not significantly differ at CA. For the SPECT-group overall sensitivity and specificity for localisation of stenoses was 77% and 84%. Respective values for the PET-group were 97% and 84%. The specificity of MPI by SPECT in the detection of ischemia was 74% and 91% for MPI by PET. The diagnostic accuracy of MPI improves when the individual coronary dominance and previous coronary revascularisations are taken into account.
  
  
  CONCLUSIONS
  MPI by (13)N-ammonia PET is more sensitive in the detection and localisation of coronary stenoses, and more specific in the detection of ischemia than MPI by (201)TlCl/(99m)MIBI SPECT.
authors.affiliation: Cardiovascular Center, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland.
authors.forename: Lars
authors.initials: L
authors.lastname: Husmann
authors.forename: Mischa
authors.initials: M
authors.lastname: Wiegand
authors.forename: Ines
authors.initials: I
authors.lastname: Valenta
authors.forename: Oliver
authors.initials: O
authors.lastname: Gaemperli
authors.forename: Tiziano
authors.initials: T
authors.lastname: Schepis
authors.forename: Patrick T
authors.initials: PT
authors.lastname: Siegrist
authors.forename: Mehdi
authors.initials: M
authors.lastname: Namdar
authors.forename: Christophe A
authors.initials: CA
authors.lastname: Wyss
authors.forename: Hatem
authors.initials: H
authors.lastname: Alkadhi
authors.forename: Philipp A
authors.initials: PA
authors.lastname: Kaufmann
mesh_terms: D000328:Adult; D000368:Aged; D000641:Ammonia; D017023:Coronary Angiography; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D009590:Nitrogen Radioisotopes; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017256:Technetium Tc 99m Sestamibi; D013793:Thallium; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D009590:Nitrogen Radioisotopes; D019275:Radiopharmaceuticals; C027549:thallium chloride; D000641:Ammonia; D017256:Technetium Tc 99m Sestamibi; D013793:Thallium