Cardiac image fusion from stand-alone SPECT and CT: clinical experience

Gaemperli, Oliver; Schepis, Tiziano; Valenta, Ines; Husmann, Lars; Scheffel, Hans; Duerst, Victor; Eberli, Franz R; Luscher, Thomas F; Alkadhi, Hatem; Kaufmann, Philipp A (2007). Cardiac image fusion from stand-alone SPECT and CT: clinical experience. Journal of nuclear medicine, 48(5), pp. 696-703. New York, N.Y.: Society of Nuclear Medicine 10.2967/jnumed.106.037606

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Myocardial perfusion imaging with SPECT (SPECT-MPI) and 64-slice CT angiography (CTA) are both established techniques for the noninvasive evaluation of coronary artery disease (CAD). Three-dimensional (3D) SPECT/CT image fusion may offer an incremental diagnostic value by integrating both sets of information. We report our first clinical experiences with fused 3D SPECT/CT in CAD patients. METHODS: Thirty-eight consecutive patients with at least 1 perfusion defect on SPECT-MPI (1-d adenosine stress/rest SPECT with (99m)Tc-tetrofosmin) and 64-slice CTA were included. 3D volume-rendered fused SPECT/CT images were generated and compared with the findings from the side-by-side analysis with regard to coronary lesion interpretation by assigning the perfusion defects to their corresponding coronary lesion. RESULTS: The fused SPECT/CT images added information on pathophysiologic lesion severity in 27 coronary stenoses (22%) of 12 patients (29%) (P<0.001). Among 40 equivocal lesions on side-by-side analysis, the fused interpretation confirmed hemodynamic significance in 14 lesions and excluded functional relevance in 10 lesions. In 3 lesions, assignment of perfusion defect and coronary lesion appeared to be reliable on side-by-side analysis but proved to be inaccurate on fused interpretation. Added diagnostic information by SPECT/CT was more commonly found in patients with stenoses of small vessels (P=0.004) and involvement of diagonal branches (P=0.01). CONCLUSION: In addition to being intuitively convincing, 3D SPECT/CT fusion images in CAD may provide added diagnostic information on the functional relevance of coronary artery lesions.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
UniBE Contributor:	Eberli, Franz
ISSN:	0161-5505
ISBN:	17475956
Publisher:	Society of Nuclear Medicine
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 14:55
Last Modified:	05 Dec 2022 14:17
Publisher DOI:	10.2967/jnumed.106.037606
PubMed ID:	17475956
Web of Science ID:	000246326100013
URI:	https://boris.unibe.ch/id/eprint/23232 (FactScience: 40662)