title: Comparison of coronary flow reserve estimated by dynamic radionuclide SPECT and multi-detector x-ray CT.
abstract: Recent technical advances in multi-detector computed tomography (MDCT) allow for assessment of coronary flow reserve (CFR). We compared regional CFR by dynamic SPECT and by dynamic MDCT in patients with suspected or known coronary artery disease (CAD).
  
  
  
  Thirty-five patients, (29 males, mean age 69 years) with greater than average Framingham risk of CAD, underwent dipyridamole vasodilator stress imaging. CFR was estimated using dynamic SPECT and dynamic MDCT imaging in the same patients. Myocardial perfusion findings were correlated with obstructive CAD (≥50% luminal narrowing) on CT coronary angiography (CA).
  
  
  
  Mean CFR estimated by SPECT and MDCT in 595 myocardial segments was not different (1.51 ± 0.46 vs. 1.50 ± 0.37, p = NS). Correlation of segmental CFR by SPECT and MDCT was fair (r2= 0.39, p < 0.001). Bland-Altman analysis revealed that MDCT in comparison to SPECT systematically underestimated CFR in higher CFR ranges. By CTCA, 12 patients had normal CA, 11 had non-obstructive, and 12 had obstructive CAD. CFR by both techniques was significantly higher in territories of normal CA than in territories subtended by non-obstructive or obstructive CAD. SPECT CFR was also significantly different in territories subtended by non-obstructive and obstructive CAD, whereas MDCT CFR was not.
  
  
  
  Despite relative underestimation of high CFR values, MDCT CFR shows promise for assessing the pathophysiological significance of anatomic CAD.
authors.affiliation: CNR Institute of Bioimaging and Molecular Physiology, Milan, Section of Genoa, Italy.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Marini
authors.affiliation: Interventional Radiology, IRCCS-AOU San Martino-IST, Genoa, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Seitun
authors.affiliation: Clinic of Cardiovascular Diseases, IRCCS-AOU San Martino-IST, Genoa, Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Zawaideh
authors.affiliation: Nuclear Medicine, IRCCS-AOU San Martino-IST, Genoa, Italy. bauckneht@yahoo.com.
authors.forename: Matteo
authors.initials: M
authors.lastname: Bauckneht
authors.affiliation: Interventional Radiology, IRCCS-AOU San Martino-IST, Genoa, Italy.
authors.forename: Margherita Castiglione
authors.initials: MC
authors.lastname: Morelli
authors.affiliation: Clinic of Cardiovascular Diseases, IRCCS-AOU San Martino-IST, Genoa, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Ameri
authors.affiliation: Nuclear Medicine, IRCCS-AOU San Martino-IST, Genoa, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Ferrarazzo
authors.affiliation: Interventional Radiology, IRCCS-AOU San Martino-IST, Genoa, Italy.
authors.forename: Irilda
authors.initials: I
authors.lastname: Budaj
authors.affiliation: Clinic of Cardiovascular Diseases, IRCCS-AOU San Martino-IST, Genoa, Italy.
authors.forename: Manrico
authors.initials: M
authors.lastname: Balbi
authors.affiliation: Nuclear Medicine, IRCCS-AOU San Martino-IST, Genoa, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Fiz
authors.affiliation: Interventional Radiology, IRCCS-AOU San Martino-IST, Genoa, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Boccalini
authors.affiliation: Interventional Radiology, IRCCS-AOU San Martino-IST, Genoa, Italy.
authors.forename: Athena Galletto
authors.initials: AG
authors.lastname: Pregliasco
authors.affiliation: Nuclear Medicine, IRCCS-AOU San Martino-IST, Genoa, Italy.
authors.forename: Ambra
authors.initials: A
authors.lastname: Buschiazzo
authors.affiliation: DITEN, University of Genoa, Genoa, Italy.
authors.forename: Alice
authors.initials: A
authors.lastname: Saracco
authors.affiliation: Health Physics, IRCCS-AOU San Martino-IST, Genoa, Italy.
authors.forename: Maria Claudia
authors.initials: MC
authors.lastname: Bagnara
authors.affiliation: Epidemiology Unit, IRCCS-AOU San Martino-IST, Genoa, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bruzzi
authors.affiliation: Clinic of Cardiovascular Diseases, IRCCS-AOU San Martino-IST, Genoa, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Brunelli
authors.affiliation: Interventional Radiology, IRCCS-AOU San Martino-IST, Genoa, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Ferro
authors.affiliation: Clinic of Cardiovascular Diseases, IRCCS-AOU San Martino-IST, Genoa, Italy.
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Bezante
authors.affiliation: Nuclear Medicine, IRCCS-AOU San Martino-IST, Genoa, Italy.
authors.forename: Gianmario
authors.initials: G
authors.lastname: Sambuceti
mesh_terms: D000368:Aged; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003326:Coronary Circulation / Q000502:physiology; D004176:Dipyridamole; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D008297:Male; D055414:Myocardial Perfusion Imaging; D012306:Risk; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
chemical_list: D004176:Dipyridamole
keywords: Coronary flow reserve; SPECT; coronary artery disease; x-ray computed tomography