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Sixty-four slice spiral CT angiography does not predict the functional relevance of coronary artery stenoses in patients with stable angina

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to evaluate spiral multidetector computed tomography (MDCT) angiography using 64-slice technique in the detection of functionally relevant coronary artery stenoses (CAS).

Methods

Thirty-eight patients (62±11 years, 28 men) with stable angina (26 with suspected and 12 with known coronary artery disease) were investigated using 64-slice MDCT angiography and gated myocardial perfusion SPECT (gated SPECT); a subgroup of 30 patients had additional invasive coronary angiography (ICA). Stenoses with luminal narrowing of ≥50% were defined as “significant” in MDCT angiography and ICA. MDCT angiography was compared with gated SPECT and the combination of gated SPECT plus ICA with respect to the detection of functionally relevant CAS.

Results

The sensitivity, specificity and negative and positive predictive values of MDCT angiography in detecting reversible perfusion defects on gated SPECT were 63%, 80%, 94% and 32%, respectively, in vessel-based analysis and 71%, 62%, 72% and 60%, respectively, in patient-based analysis. If only reversible perfusion defects on gated SPECT with CAS ≥50% on ICA were considered, the sensitivity, specificity and negative and positive predictive values were, respectively, 85%, 79%, 98% and 33% for vessel-based analysis and 85%, 59%, 83% and 61% for patient-based analysis.

Conclusion

Sixty-four slice MDCT angiography failed to predict the functional relevance of CAS, but had a high negative predictive value in the exclusion of functionally relevant CAS in symptomatic patients.

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Acknowledgments

We are grateful for the support and technical assistance of the staff of the Departments of Nuclear Medicine and Radiology at the University of Munich.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Ludwig-Maximilians-University, Ziemssenstrasse 1, 80336, Munich, Germany

    Marcus Hacker, Nicolas Hack, Klaus Hahn & Reinhold Tiling

  2. Department of Clinical Radiology, Ludwig-Maximilians-University, Munich, Germany

    Tobias Jakobs, Konstantin Nikolaou, Christoph Becker & Maximilian Reiser

  3. Department of Cardiology, Klinikum Grosshadern, Ludwig-Maximilians-University, Munich, Germany

    Franz von Ziegler & Andreas Knez

  4. Department of Cardiology, Medizinische Poliklinik-Innenstadt, Ludwig-Maximilians-University, Munich, Germany

    Andreas König & Volker Klauss

Authors
  1. Marcus Hacker
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  2. Tobias Jakobs
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  3. Nicolas Hack
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  4. Konstantin Nikolaou
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  5. Christoph Becker
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  6. Franz von Ziegler
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  7. Andreas Knez
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  8. Andreas König
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  9. Volker Klauss
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  10. Maximilian Reiser
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  11. Klaus Hahn
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  12. Reinhold Tiling
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Corresponding author

Correspondence to Marcus Hacker.

Additional information

An editorial commentary on this paper is available at http://dx.doi.org/10.1007/s00259-006-0204-5.

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Hacker, M., Jakobs, T., Hack, N. et al. Sixty-four slice spiral CT angiography does not predict the functional relevance of coronary artery stenoses in patients with stable angina. Eur J Nucl Med Mol Imaging 34, 4–10 (2007). https://doi.org/10.1007/s00259-006-0207-2

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  • DOI: https://doi.org/10.1007/s00259-006-0207-2

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