Cardiac Image Fusion from Stand-Alone SPECT and CT: Clinical Experience

Journal of Nuclear Medicine

Tiziano Schepis¹  Ines Valenta¹  Thomas F. Luscher¹  Victor Duerst¹  Oliver Gaemperli¹  Franz R. Eberli¹  Hatem Alkadhi¹  Lars Husmann¹  Hans Scheffel¹  Philipp A. Kaufmann¹ 

关键词: myocardial perfusion imaging;    SPECT;    coronary CT angiography;    SPECT/CT fusion;    coronary artery disease;   

DOI  :  10.2967/jnumed.106.037606

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

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 99mTc-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.

【 授权许可】

Unknown