Evaluation of combined cardiac positron emission tomography and coronary computed tomography angiography for the detection of coronary artery disease.
BACKGROUND
Coronary artery disease is a leading cause of morbidity and mortality. Multiple imaging modalities are used to screen for significant coronary artery disease. We report the concordance between coronary computed tomography angiography (CTA) and stress cardiac positron emission tomography (CPET) to detect significant coronary artery disease, the feasibility of combining CTA and CPET in one diagnostic test, and the ability of CTA and CPET to detect significant coronary artery disease by comparison with cardiac catheterization.


METHODS
Forty patients were prospectively enrolled and imaged with a hybrid PET/CT scanner. Eighteen patients had cardiac catheterization data for comparison. Concordance of findings between diagnostic tests was assessed by examining overall percentage in agreement, area under the receiver operating characteristic curve, sensitivity, specificity, and positive and negative predictive values.


RESULTS
The overall agreement between CTA and CPET for detecting significant coronary artery disease was 76.3% with a sensitivity and specificity of 91.7 and 69.2%, respectively. The overall agreement between CTA and cardiac catheterization for detecting significant coronary artery disease was 81.3% with a sensitivity and specificity of 81.8 and 80.0%, respectively. The overall agreement between CPET and cardiac catheterization for detecting significant coronary artery disease was 77.8% with a sensitivity and specificity of 76.9 and 80.0%, respectively.


CONCLUSIONS
CTA and CPET can be performed in a single diagnostic test interval to simultaneously assess the extent of coronary artery disease and its hemodynamic significance. The sensitivity and specificity of CTA and CPET are similar to existing noninvasive screening tests.
Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA.
George L
GL
Adams
Mark A
MA
Trimble
Rhoda B
RB
Brosnan
Cheryl A
CA
Russo
Dan
D
Rusband
Emily F
EF
Honeycutt
Linda K
LK
Shaw
Lynn M
LM
Hurwitz
Timothy G
TG
Turkington
Michael W
MW
Hanson
Robert A
RA
Pagnanelli
Salvador
S
Borges-Neto
D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*