Incremental diagnostic accuracy of hybrid SPECT/CT coronary angiography in a population with an intermediate to high pre-test likelihood of coronary artery disease

Schaap, Jeroen; Kauling, Robert M; Boekholdt, S. Matthijs; Nieman, Koen; Meijboom, Willem B.; Post, Martijn C.; Heyden, Jan A Van der; Kroon, Thom L. de; Es, Hendrik W. van; Rensing, Benno J.; Verzijlbergen, J. Fred

doi:10.1093/ehjci/jes303

Cited by 47 publications

(17 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, the CT was used only for reconstructing attenuation maps and AC in these CT AC studies. We propose that if scatter correction (39) and anatomic information such as coronary calcium or angiography from CT (40,41) could be applied, the diagnostic performance may show even greater improvement.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Performance of Attenuation-Corrected Myocardial Perfusion Imaging for Coronary Artery Disease: A Systematic Review and Meta-Analysis

Huang

Yen

et al. 2016

J Nucl Med

View full text Add to dashboard Cite

Myocardial perfusion imaging (MPI) with SPECT is a well-established tool for the diagnosis of coronary artery disease (CAD). However, soft-tissue attenuation is a common artifact that limits the diagnostic accuracy of MPI. The aim of this study was to determine whether attenuation correction (AC) improved the diagnostic performance of MPI, using coronary angiography as a reference standard. Methods: MEDLINE and EMBASE were searched until March 2015 for studies evaluating AC MPI for the diagnosis of CAD. Methodologic quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. For each study, the sensitivity, specificity, and diagnostic odds ratio, along with 95% confidence intervals (CIs), were calculated to determine the diagnostic accuracy of AC versus nonattenuation-corrected (NAC) MPI. A bivariate mixed-effects model was applied for pooling the data. Results: Of 201 articles, 17 studies (1,701 patients) were identified, including 5 studies that used CT AC, 12 studies that used radionuclide source AC (RAC), and 15 studies that reported NAC results. The pooled sensitivities across studies were 0. 95% CI, 24 (95% CI, 22 (95% CI,, and 9 (7-11). Significant differences in specificity and diagnostic odds ratios were noted when AC (including CT AC, RAC, and all AC) was compared with NAC. Conclusion: The results from this study suggested that AC should be applied to MPI to improve the diagnosis of CAD, especially the specificity.

show abstract

Section: Discussionmentioning

confidence: 99%

Diagnostic Performance of Attenuation-Corrected Myocardial Perfusion Imaging for Coronary Artery Disease: A Systematic Review and Meta-Analysis

Huang

Yen

et al. 2016

J Nucl Med

View full text Add to dashboard Cite

show abstract

“…109,110 Diverse combinations of hybrid imaging of myocardial perfusion (CT + SPECT, CT + PET and CT + CMR) are gaining increasing interest because they provide both anatomic and functional information, improving the overall performance of the diagnostic test.…”

Section: Hybrid Devices Computed Tomography Nuclear Imagementioning

confidence: 99%

Novel Imaging Techniques for Heart Failure

Melero-Ferrer

López‐Vilella

Morillas-Climent

et al. 2016

Cardiac Failure Review

View full text Add to dashboard Cite

Heart failure (HF) is an epidemic with an increasing prevalence and an absolute mortality rate of approximately 50 % within 5 years of diagnosis. Imaging plays a main role in HF diagnosis, assessment of aetiology and treatment guidance. This article reviews current HF applications for all the available non-invasive imaging modalities: echocardiography, cardiovascular magnetic resonance (CMR), nuclear imaging-positron emission tomography (PET) and single-photon emission computed tomography (SPECT) and computed tomography (CT). Echocardiography, with its recent developments, such as 3D echo, is the main imaging test used in the evaluation of HF patients, given its availability and reliability in assessing cardiac structure and function. CMR allows the characterisation of myocardial tissue, in addition to providing information on the structure and cardiac function, so it is a great help in the determination of HF aetiology and may predict patient outcomes. Nuclear imaging can detect ischaemia and viability and can obtain additional prognostic data. Cardiac CT is EchocardiographyAlthough echocardiography is a relatively 'ancient' technique, its versatility makes it unique in the provision of volumes, function, haemodynamics or valvular regurgitation. In addition, because of its availability, safety and low cost, echocardiography is the first and most widely used test for the diagnosis, selection of appropriate treatment and prognosis of HF.1 Echocardiography is also the most used imaging method in the reassessment of HF patients. It remains unclear when to repeat echocardiographic exams, but it is deemed appropriate at least in patients with worsening symptoms. Systolic FunctionGlobal left ventricular (LV) function is of paramount importance regarding therapeutic decisions. Visual estimation of ejection fraction (EF), the Teichholz and Simpson methods, have been widely validated. 2,3However, in 2D imaging, because of its operator-dependent nature, repeated testing has a high probability of producing variable volume and EF results.The apparition of 3D fully sampled matrix transthoracic echocardiography has enabled easier acquisition of images, 4 simplifying its routinary application. There have been many studies comparing 2D and 3D echocardiography (2DE and 3DE) and a 'reference' standard (generally CMR). A recent meta-analysis of all 3DE studies evaluating LV volumes and EF demonstrated that 3DE generally underestimated volumes, but not as significantly as 2DE. There was also less variability than 2D compared with CMR.5 Nonetheless, 3DE echocardiography may be challenging and not practical in patients with low image quality (e.g. critical patients), in whom 2DE measures are more realiable. 3DE is also a less standardised techique than 2DE, and because of this reason most laboratories use the more universally applicable 2DE measurements in clinical practice. Only recently, large analyses of LV parameters using 3DE in large cohorts of healthy individuals have been published to establish race, age and gender-specific ...

show abstract

“…These characteristics make it suitable for use in patients with asthma or mild/moderate chronic obstructive pulmonary disease. 48 Schaap et al 49 have indicated that hybrid SPECT-CT images have higher specificity than either of these techniques used alone for diagnosing ischemic heart disease in populations with an intermediate or high pretest probability of having this condition.…”

Section: Nuclear Cardiologymentioning

confidence: 99%