Clinical usefulness of novel cardiac MDCT/SPECT fusion image.
BACKGROUND
We evaluated the relationship between computed tomography angiography (CTA) and SPECT, and assessed to determine the clinical usefulness of the fusion image using CTA and myocardial perfusion imaging (MPI).


METHODS
Forty-one consecutive patients [after coronary artery bypass operation (n = 13) and suspected stenosis (n = 28)] underwent MPI and CTA. SPECT/CTA fused images were generated.


RESULTS
In total, 687 segments including bypass graft in 164 coronary arteries were analyzed. Myocardial ischemia on MPI was observed in 11 patients among 28 with CTA abnormalities, one had both ischemia and infarction, and 7 had only infarction. Segment-based analysis showed that ischemia was found in 14 segments (24%) among 59 stenoses on CTA. Forty stenotic segments (69%) were not associated with perfusion abnormality. The rest 5 stenotic segments were considered equivocal (8%). A fusion image made it possible to associate perfusion defects with its corresponding coronary artery in 4 out of 5 equivocal lesions on side-by-side analysis. Patients with incremental diagnostic information on SPECT/CTA fusion (n = 4) had significant smaller coronary diameter than that of not-improved coronary vessels (2.0 +/- 0.4 vs. 3.9 +/- 0.4 mm, p = 0.001).


CONCLUSIONS
Cardiac fusion imaging accurately diagnosed functionally relevant coronary stenosis. SPECT/CTA fusion images in coronary artery disease may provide added diagnostic information on functional relevance of coronary artery disease.
Matsuo
Shinro
S
Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa 920-8641, Japan. smatsuo@nmd.m.kanazawa-u.ac.jp
Nakajima
Kenichi
K
Akhter
Nasima
N
Wakabayashi
Hiroshi
H
Taki
Junichi
J
Okuda
Koichi
K
Kinuya
Seigo
S
D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D012189:Retrospective Studies; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*