title: Fused cardiac hybrid imaging with coronary computed tomography angiography and positron emission tomography in patients with complex coronary artery anomalies.
abstract: OBJECTIVE
  To provide data on the value of fused cardiac hybrid imaging with coronary computed tomography angiography (CCTA) and positron emission tomography myocardial perfusion imaging (PET-MPI) in patients with complex coronary artery anomalies (CCAA).
  
  
  METHODS
  This is a retrospective, single-center study.
  
  
  METHODS
  Seven consecutive patients with CCAA (mean 57 ± 7 y, 86% were male) who underwent clinically indicated hybrid CCTA/PET-MPI between 2005 and 2015 in our clinic were included. The findings from both modalities and fused cardiac hybrid imaging were evaluated in these patients.
  
  
  RESULTS
  Out of the seven patients with CCAA, two patients had Bland-White-Garland anomaly, two patients showed a coronary artery fistula, two patients showed a "single right," and one patient showed a "single left" coronary artery. Semiquantitative fused hybrid CCTA/PET-MPI depicted inferolateral scar matching the territory of a nonanomalous vessel with significant concomitant coronary artery disease (CAD) in one patient only. In contrast, analysis of quantitative myocardial blood flow (MBF) as assessed by fused hybrid CCTA/PET-MPI revealed abnormally reduced flow capacities in the territories subtended by the anomalous vessels in 4 patients.
  
  
  CONCLUSIONS
  In this case series of middle-aged patients with CCAA, perfusion defects as assessed by semiquantitative PET-MPI were rare and attributable to concomitant CAD rather than to the anomalous vessel itself. By contrast, impaired MBF as assessed by quantitative hybrid CCTA/PET-MPI was revealed in the majority of patients in the vessel territories subtended by the anomalous coronary artery itself. Fused hybrid CCTA/PET-MPI incorporating information on morphology and on semiquantitative and quantitative myocardial perfusions may provide added value for the management of patients with CCAA.
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Gräni
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Dominik C
authors.initials: DC
authors.lastname: Benz
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Mathias
authors.initials: M
authors.lastname: Possner
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Olivier F
authors.initials: OF
authors.lastname: Clerc
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Fran
authors.initials: F
authors.lastname: Mikulicic
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Jan
authors.initials: J
authors.lastname: Vontobel
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Julia
authors.initials: J
authors.lastname: Stehli
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Tobias A
authors.initials: TA
authors.lastname: Fuchs
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Aju P
authors.initials: AP
authors.lastname: Pazhenkottil
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Oliver
authors.initials: O
authors.lastname: Gaemperli
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Philipp A
authors.initials: PA
authors.lastname: Kaufmann
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Ronny R
authors.initials: RR
authors.lastname: Buechel
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003326:Coronary Circulation; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D055420:Perfusion Imaging / Q000379:methods*; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D013557:Switzerland
keywords: coronary artery anomalies; coronary computed tomography; fused; hybrid; positron emission tomography myocardial perfusion