title: Direct comparison of rest and adenosine stress myocardial perfusion CT with rest and stress SPECT.
abstract: BACKGROUND
  We have recently described a technique for assessing myocardial perfusion using adenosine-mediated stress imaging (CTP) with dual source computed tomography. SPECT myocardial perfusion imaging (SPECT-MPI) is a widely utilized and extensively validated method for assessing myocardial perfusion. The aim of this study was to determine the level of agreement between CTP and SPECT-MPI at rest and under stress on a per-segment, per-vessel, and per-patient basis.
  
  
  METHODS
  Forty-seven consecutive patients underwent CTP and SPECT-MPI. Perfusion images were interpreted using the 17 segment AHA model and were scored on a 0 (normal) to 3 (abnormal) scale. Summed rest and stress scores were calculated for each vascular territory and patient by adding corresponding segmental scores.
  
  
  RESULTS
  On a per-segment basis (n = 799), CTP and SPECT-MPI demonstrated excellent correlation: Goodman-Kruskall gamma = .59 (P < .0001) for stress and .75 (P < .0001) for rest. On a per-vessel basis (n = 141), CTP and SPECT-MPI summed scores demonstrated good correlation: Pearson r = .56 (P < .0001) for stress and .66 (P < .0001) for rest. On a per-patient basis (n = 47), CTP and SPECT-MPI demonstrated good correlation: Pearson r = .60 (P < .0001) for stress and .76 (P < .0001) for rest.
  
  
  CONCLUSIONS
  CTP compares favorably with SPECT-MPI for detection, extent, and severity of myocardial perfusion defects at rest and stress.
authors: Cardiac MR PET CT Program, Department of Radiology and Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
authors: David R
authors: DR
authors: Okada
authors: Brian B
authors: BB
authors: Ghoshhajra
authors: Ron
authors: R
authors: Blankstein
authors: Jose A
authors: JA
authors: Rocha-Filho
authors: Leonid D
authors: LD
authors: Shturman
authors: Ian S
authors: IS
authors: Rogers
authors: Hiram G
authors: HG
authors: Bezerra
authors: Ammar
authors: A
authors: Sarwar
authors: Henry
authors: H
authors: Gewirtz
authors: Udo
authors: U
authors: Hoffmann
authors: Wilfred S
authors: WS
authors: Mamuya
authors: Thomas J
authors: TJ
authors: Brady
authors: Ricardo C
authors: RC
authors: Cury
mesh_terms: D000241:Adenosine; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012146:Rest; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents; D000241:Adenosine