Direct comparison of rest and adenosine stress myocardial perfusion CT with rest and stress SPECT

David R. Okada BA, Brian B. Ghoshhajra MD, Ron Blankstein MD, Jose A. Rocha-Filho MD, Leonid D. Shturman MD, Ian S. Rogers MD, Hiram G. Bezerra MD, Ammar Sarwar MD, Henry Gewirtz MD, Udo Hoffmann MD, PhD, Wilfred S. Mamuya MD, PhD, Thomas J. Brady MD, Ricardo C. Cury MD
Original Article
Volume 17, Issue 1 / February , 2010

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Introduction

We have recently described a technique for assessing myocardial perfusion using adenosine-mediated stress imaging (CTP) with dual source computed tomography. SPECT myocardial perfusion imaging (SPECT-MPI) is a widely utilized and extensively validated method for assessing myocardial perfusion. The aim of this study was to determine the level of agreement between CTP and SPECT-MPI at rest and under stress on a per-segment, per-vessel, and per-patient basis.

Methods

Forty-seven consecutive patients underwent CTP and SPECT-MPI. Perfusion images were interpreted using the 17 segment AHA model and were scored on a 0 (normal) to 3 (abnormal) scale. Summed rest and stress scores were calculated for each vascular territory and patient by adding corresponding segmental scores.

Results

On a per-segment basis (n = 799), CTP and SPECT-MPI demonstrated excellent correlation: Goodman-Kruskall γ = .59 (P < .0001) for stress and .75 (P < .0001) for rest. On a per-vessel basis (n = 141), CTP and SPECT-MPI summed scores demonstrated good correlation: Pearson r = .56 (P < .0001) for stress and .66 (P < .0001) for rest. On a per-patient basis (n = 47), CTP and SPECT-MPI demonstrated good correlation: Pearson r = .60 (P < .0001) for stress and .76 (P < .0001) for rest.

Conclusions

CTP compares favorably with SPECT-MPI for detection, extent, and severity of myocardial perfusion defects at rest and stress.

Keywords

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