Myocardial perfusion imaging with a cadmium zinc telluride-based gamma camera versus invasive fractional flow reserve
Publication year
2014Source
European Journal of Nuclear Medicine and Molecular Imaging, 41, 5, (2014), pp. 956-962ISSN
Publication type
Article / Letter to editor

Display more detailsDisplay less details
Organization
Cardiology
Radboudumc Extern
Nuclear Medicine
Journal title
European Journal of Nuclear Medicine and Molecular Imaging
Volume
vol. 41
Issue
iss. 5
Page start
p. 956
Page end
p. 962
Subject
Radboudumc 16: Vascular damage RIHS: Radboud Institute for Health SciencesAbstract
PURPOSE: Recently introduced ultrafast cardiac SPECT cameras with cadmium zinc telluride-based (CZT) detectors may provide superior image quality allowing faster acquisition with reduced radiation doses. Although the level of concordance between conventional SPECT and invasive fractional flow reserve (FFR) measurement has been studied, that between FFR and CZT-based SPECT is not yet known. Therefore, we aimed to assess the level of concordance between CZT SPECT and FFR in a large patient group with stable coronary artery disease. METHODS: Both invasive FFR and myocardial perfusion imaging with a CZT-based SPECT camera, using Tc-tetrofosmin as tracer, were performed in 100 patients with stable angina and intermediate grade stenosis on invasive coronary angiography. A cut-off value of <0.75 was used to define abnormal FFR. RESULTS: The mean age of the patients was 64 +/- 11 years, and 64 % were men. SPECT demonstrated ischaemia in 31 % of the patients, and 20 % had FFR <0.75. The concordance between CZT SPECT and FFR was 73 % on a per-patient basis and 79 % on a per-vessel basis. Discordant findings were more often seen in older patients and were mainly (19 %) the result of ischaemic SPECT findings in patients with FFR >/= 0.75, whereas only 8 % had an abnormal FFR without ischaemia as demonstrated by CZT SPECT. CONCLUSION: Only 20 - 30 % of patients with intermediate coronary stenoses had significant ischaemia as assessed by CZT SPECT or invasive FFR. CZT SPECT showed a modest degree of concordance with FFR, which is comparable with previous results with conventional SPECT. Further investigations are particularly necessary in patients with normal SPECT and abnormal FFR, especially to determine whether these patients should undergo revascularization.
This item appears in the following Collection(s)
- Academic publications [204994]
- Faculty of Medical Sciences [81051]
Upload full text
Use your RU credentials (u/z-number and password) to log in with SURFconext to upload a file for processing by the repository team.