Patient Characteristics (n = 208) by ICA, FFR, CCTA, SPECT and PET, eTable 3. Study concept and design: Danad, Raijmakers, Tulevski, Somsen, Lammertsma, Knaapen. For LAD and LAD/diagonal bifurcation visualization the cranial views are most useful. Dr Knuuti reported receiving support from the Academy of Finland Centre of Excellence in Molecular Imaging in Cardiovascular and Metabolic Research, Helsinki, Finland, and receiving grant support from Gilead Inc and serving as a consultant to Lantheus Inc. Dr Min reported serving as a consultant to HeartFlow and Abbott Vascular, serving on the scientific advisory board of Arineta, and holding an equity interest in MDDX. Comparison of Coronary CT Angiography, SPECT, PET, and Hybrid Imaging for Diagnosis of Ischemic Heart Disease Determined by Fractional Flow Reserve.  TF, deKemp  D, Caselli  JP, Ripley Of the 208 patients in the study (76 women and 132 men; mean [SD] age, 58 [9] years), 92 (44.2%) had significant CAD (fractional flow reserve ≤0.80). Study supervision: Raijmakers, Tulevski, Huisman, van Kuijk, Lammertsma, Knaapen. (Level of Evidence: C) 3. Underestimation of extent of ischemia by gated SPECT myocardial perfusion imaging in patients with left main coronary artery disease. The mean (SD) dose (including low-dose CCTA) was 6.01 (0.70) mSv for SPECT and 3.10 mSv for PET MPI. The mean (SD) radiation dose of CCTA was 5.31 (1.32) mSv. Impact of attenuation correction and gated acquisition in SPECT myocardial perfusion imaging: results of the multicentre SPAG (SPECT Attenuation Correction vs Gated) study. Statistical analysis: Danad, Driessen, Stuijfzand, Heymans, van de Ven, Knaapen. You should seek immediate medical attention if swelling at the site of your wound gets worse, or if you experience excessive bleeding or circulation problems in your limbs. This study has some limitations. How would you follow up on the negative imaging result? However, to date, prospective head-to-head studies are lacking regarding the diagnostic accuracy of these imaging modalities. CT coronary angiography or CCTA is a better procedure as compared to other imaging studies for the heart blood vessels as it has many benefits:. The Fractional Flow Reserve vs Angiography for Multivessel Evaluation (FAME) trial has demonstrated FFR to be a prognostic and clinical criterion standard, given its ability to guide decisions of revascularization in a manner that results in improvement in event-free survival over stenosis-guided revascularization.5,7 More important, in the FAME study, 47% of lesions were considered intermediate in stenosis severity, and approximately one-third of these lesions resulted in coronary ischemia, while two-thirds did not.13 In this regard, our study advances the understanding of the association of noninvasive testing and the use of FFR as a reference standard. Patients underwent CCTA, PET, and SPECT, followed by invasive coronary angiography (ICA) and FFR measurements of all coronary arteries within 2 weeks. To our knowledge, these data represent the first comprehensive examination of commonly used noninvasive techniques to evaluate myocardial perfusion or severity of coronary artery stenosis. When the roentgenographic exposure is made during or immediately after the injection of contrast medium, an arteriogram is obtained. Published Online: August 16, 2017. doi:10.1001/jamacardio.2017.2471. Angiography contrast material can damage your kidneys, so you may not be able to have this test if you have severe kidney disease or diabetes.  J, Gaur Three Examples of CCTA, SPECT, PET, Hybrid PET/CCTA and Angiographic Findings, eFigure 3. Background PCI is the most effective method to improve the outcomes of CAD. At that time, the radiology nurse will … Clinical value of absolute quantification of myocardial perfusion with. Coronary angiography may be done if: You have angina for the first time.  U, Achenbach The mean (SD) diameter stenosis of atherosclerotic plaques causing ischemia was 60% (18%). What are the diagnostic performances of coronary computed tomography angiography, single-photon emission tomography, [15O]H2O positron emission tomography, and hybrid imaging for the diagnosis of myocardial ischemia using fractional flow reserve as a reference standard? II. Medication was not discontinued and was kept constant during the execution of the study protocol. Hemodynamically significant stenosis in at least 1 coronary artery as indicated by a fractional flow reserve of 0.80 or less and relative diagnostic accuracy of SPECT, PET, and CCTA in detecting hemodynamically significant CAD. The X-rays provided by an angiography are called angiograms. Association Between Functional Extent of Coronary Artery Disease and Noninvasive Imaging, eTable 4. On PET scans, myocardial segments with a hyperemic myocardial blood flow of 2.30 mL/min/g or less were considered to be abnormal.  H, Dr van Royen reported receiving educational grants from Baxter and Biotronik.
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