title: Clinical usefulness of combinatorial protocol with stress only myocardial perfusion SPECT, CTA and SPECT/CTA 3-dimensional fusion image.
abstract: BACKGROUND
  This study was designed to assess the value of a combinatorial protocol, namely, stress only myocardial perfusion SPECT (MPS), 64-slice coronary computed tomographic angiography (CTA), and SPECT/CTA 3-dimensional (3D) fusion imaging for the evaluation of coronary artery disease.
  
  
  METHODS
  A total of 142 patients were retrospectively reviewed. All underwent stress only MPS and 64-slice CTA before invasive coronary angiography (ICA). The SPECT/CTA 3D fusion images were generated. We compared the results of the combinatorial protocol with ICA.
  
  
  RESULTS
  Seventy nine (76.0%) subjects were found to have ≥50% stenoses, by ICA. The sensitivity of the combinatorial examination was 100% and its specificity 80.8%. Its positive and negative predictive values were 94.0 and 100%, respectively. The number of lesion for abnormal MPS with matching significant stenoses on CTA is 94 [43 in left anterior descending (LAD); 19 in left circumflex (LCX); 32 in right coronary artery (RCA)], the number of lesion for equivocal perfusion defect with matching stenoses on CTA is 24 (14 in LAD; 7 in LCX; 3 in RCA). The number of coronary arterial stenoses without MPS abnormality is 10, 4 stenoses were detected in left main lesion and the other stenoses were comparatively mild lesion in multi-vessel disease.
  
  
  CONCLUSIONS
  Stress only MPS/CTA 3D fusion imaging could provide the potential for improved diagnostic accuracy and additional information of hemodynamically relevant coronary arterial stenoses.
authors.affiliation: Department of Nuclear Medicine, Yeung-Nam University Hospital, #317-1 Daemyung 5-dong, Nam-gu, Daegu, Republic of Korea, rhddmsj@hanmail.net
authors.forename: Eun-Jung
authors.initials: EJ
authors.lastname: Kong
authors.forename: Ihn-Ho
authors.initials: IH
authors.lastname: Cho
authors.forename: Kyung-Ah
authors.initials: KA
authors.lastname: Chun
mesh_terms: D002118:Calcium / Q000378:metabolism; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013312:Stress, Physiological; D018511:Systems Integration; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D002118:Calcium