title: Impact of cardiac hybrid single-photon emission computed tomography/computed tomography imaging on choice of treatment strategy in coronary artery disease.
abstract: OBJECTIVE
  Cardiac hybrid imaging by fusing single-photon emission computed tomography (SPECT) myocardial perfusion imaging with coronary computed tomography angiography (CCTA) provides important complementary diagnostic information for coronary artery disease (CAD) assessment. We aimed at assessing the impact of cardiac hybrid imaging on the choice of treatment strategy selection for CAD.
  
  
  RESULTS
  Three hundred and eighteen consecutive patients underwent a 1 day stress/rest (99m)Tc-tetrofosmin SPECT and a CCTA on a separate scanner for evaluation of CAD. Patients were divided into one of the following three groups according to findings in the hybrid images obtained by fusing SPECT and CCTA: (i) matched finding of stenosis by CCTA and corresponding reversible SPECT defect; (ii) unmatched CCTA and SPECT finding; (iii) normal finding by both CCTA and SPECT. Follow-up was confined to the first 60 days after hybrid imaging as this allows best to assess treatment strategy decisions including the revascularization procedure triggered by its findings. Hybrid images revealed matched, unmatched, and normal findings in 51, 74, and 193 patients. The revascularization rate within 60 days was 41, 11, and 0% for matched, unmatched, and normal findings, respectively (P< 0.001 for all inter-group comparisons).
  
  
  CONCLUSIONS
  Cardiac hybrid imaging with SPECT and CCTA provides an added clinical value for decision making with regard to treatment strategy for CAD.
authors.affiliation: Department of Radiology, Cardiac Imaging,  University Hospital Zurich, Ramistrasse 100, CH-8091 Zurich,  Switzerland.
authors.forename: Aju P
authors.initials: AP
authors.lastname: Pazhenkottil
authors.forename: Rene N
authors.initials: RN
authors.lastname: Nkoulou
authors.forename: Jelena-Rima
authors.initials: JR
authors.lastname: Ghadri
authors.forename: Bernhard A
authors.initials: BA
authors.lastname: Herzog
authors.forename: Silke M
authors.initials: SM
authors.lastname: Küest
authors.forename: Lars
authors.initials: L
authors.lastname: Husmann
authors.forename: Mathias
authors.initials: M
authors.lastname: Wolfrum
authors.forename: Robert
authors.initials: R
authors.lastname: Goetti
authors.forename: Ronny R
authors.initials: RR
authors.lastname: Buechel
authors.forename: Oliver
authors.initials: O
authors.lastname: Gaemperli
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lüscher
authors.forename: Philipp A
authors.initials: PA
authors.lastname: Kaufmann
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000628:therapy; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000628:therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D009204:Myocardial Revascularization / Q000706:statistics & numerical data; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C078700:technetium tc-99m tetrofosmin