Comparison of myocardial perfusion scintigraphy and computed tomography (CT) angiography based on conventional coronary angiography


Coronary artery disease is one of the most common and important health problems in the world. Early diagnosis of this disease is very important to treat before severe myocardial damage occurred. Myocardial perfusion scintigraphy (MPS) and computed tomography coronary angiography (CTCA) which evaluates regional myocardial perfusion and coronary arteries, respectively, are reliable and non-invasive methods in terms of coronary artery disease. In this study we aimed to compare MPS and CTCA based on conventional coronary angiography (CCA). Totally 60 patients were included in the study. CCA and MPS were performed to 30 patients; CCA and CTCA were performed to the rest of the patients (30 patients). Lesions were classified as mild, moderate and severe in these imaging methods. MPS and CTCA were compared with CCA by using chi-square and Fisher’s exact test. MPS and CTCA’s p values were found for left anterior descending artery (LAD) p: 0, p: 0.271; for circumflex artery (Cx) p: 0.256, p: 0.08 and for right coronary artery (RCA) p: 0.033, p: 0.271, respectively. Furthermore MPS and CTCA’s sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated 81% to 87%; 70% to 49%; 73% to 72%; 54% to 72%; 90% to 71%, respectively. CCA results were found more concordant with MPS for LAD and RCA lesions and more concordant with CTCA for Cx lesions. It was also found that positive predictive value of MPS and negative predictive value of CTCA were significantly higher than the others. As a result, MPS and CTCA were suggested as complementary techniques for the diagnosis of coronary artery disease, not as alternatives to each other.

Share and Cite:

Tasdemir, B. , Balci, T. , Demirel, B. , Karaca, I. , Aydin, A. and Koc, Z. (2012) Comparison of myocardial perfusion scintigraphy and computed tomography (CT) angiography based on conventional coronary angiography. Natural Science, 4, 976-982. doi: 10.4236/ns.2012.412126.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Crea, F., Camici, P.G., De Caterina, R. and Lanza, G.A. (2006) Chronic ischaemic heart disease. In: Camm, A.J., Luescher, T.F. and Serruys, P.W., Eds., The ESC Textbook of Cardiovascular Medicine, Blackwell Publishing Ltd., Oxford, 391-424.
[2] Bashore, T.M., Bates, E.R., Berger, P.B., et al. (2001) American College of Cardiology/Society for Cardiac Angiography and Interventions clinical expert consensus document on cardiac catheterization laboratory standards. A report of the American College of Cardiology Task Force on clinical expert consensus documents. Journal of the American College of Cardiology, 37, 2170-2214. doi:10.1016/S0735-1097(01)01346-8
[3] Scanlon, P.J., Faxon, D.P., Audet, A.M., et al. (1999) ACC/AHA guidelines for coronary angiography. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on Coronary Angiography). Developed in collaboration with the Society for Cardiac Angiography and Interventions. Journal of the American College of Cardiology, 33, 1756-1824. doi:10.1016/S0735-1097(99)00126-6
[4] Johnson, L.W., Lozner, E.C., Johnson, S., et al. (1989) Coronary arteriography 1984-1987: A report of the Registry of the society for cardiac angiography and interventions. I. Results and complications. Catheterization and Cardiovascular Diagnosis, 17, 5-10. doi:10.1002/ccd.1810170103
[5] Gaemperli, O., Schepis, T., Valenta, I., et al. (2007) Cardiac image fusion from stand-alone SPECT and CT: clinical experience. Journal of Nuclear Medicine, 48, 696- 703. doi:10.2967/jnumed.106.037606
[6] Lau, G.T., Ridley, L.J., Schieb, M.C., et al. (2005) Coronary artery stenoses: Detection with calcium scoring, CT angiography, and both methods combined. Radiology, 235, 415-422. doi:10.1148/radiol.2352031813
[7] Schoenhagen, P., Halliburton, S.S., Stillman, A.E., et al. (2004) Noninvasive imaging of coronary arteries: Current and future role of multi detector row CT. Radiology, 232, 7-17. doi:10.1148/radiol.2321021803
[8] Schoepf, U.J., Becker, C., Ohnesorge, B.M. and Yucel, K. (2004) CT of coronary arter disease. Radiology, 232, 18- 37. doi:10.1148/radiol.2321030636
[9] Achenbach, S. (2007) Cardiac CT: State of the art for the detection of coronary arterial stenosis. Journal of Cardiovascular Computed Tomography, 1, 3-20. doi:10.1016/j.jcct.2007.04.007
[10] Lawler, L.P., Pannu, H.K. and Fishman, E.K. (2005) MDCT evaluation of the coronary arteries, 2004: How we do it—Data acquisition, postprocessing, display, and interpretation. American Journal of Roentgenology, 184, 1402-1412.
[11] Schoepf, P.D., Zwerner, P.L., Savino, G., Herzog, C., Kerl, J.M. and Costello, P. (2007) Coronary CT angiography. Radiology, 244, 48-63. doi:10.1148/radiol.2441052145
[12] Stein, P.D., Beemath, A., Kayali, F., Skaf, E., Sanchez, J. and Olson, R.E. (2006) Multidetector computed tomography for the diagnosis of coronary artery disease: A systematic review. American Journal of Medicine, 119, 203-216. doi:10.1016/j.amjmed.2005.06.071
[13] Hoffmann, U., Moselewski, F., Cury, R.C., et al. (2004) Predictive value of 16-slice multidetector spiral computed tomography to detect significant obstructive coronary artery disease in patients at high risk for coronary artery disease. Circulation, 110, 2638-2643. doi:10.1161/01.CIR.0000145614.07427.9F
[14] Nieman, K., Cademartiri, F., Lemos, P.A., et al. (2002) Reliable noninvasive coronary angiography with fast submillimeter multislice spiral computed tomography. Circulation, 106, 2051-2054. doi:10.1161/01.CIR.0000037222.58317.3D
[15] Ropers, D., Baum, U., Pohle, K., et al. (2003) Detection of coronary artery stenoses with thin-slice multi-detector row spiral computed tomography and multiplanar reconstruction. Circulation, 107, 664-666. doi:10.1161/01.CIR.0000055738.31551.A9
[16] Knez, A., Becker, C.R., Leber, A., et al. (2001) Usefulness of multislice spiral computed tomography angiography for determination of coronary artery stenoses. American Journal of Cardiology, 88, 1191-1194. doi:10.1016/S0002-9149(01)02060-4
[17] Feyter, P.J. and Achenbach, S. (2006) Cardiovascular computerized tomography. In: Camm, A.J., Luescher, T.F. and Serruys, P.W., Eds., The ESC Textbook of Cardiovascular Medicine. Blackwell Publishing Ltd., Oxford, 115- 139.
[18] Choi, H.S., Choi, B.W., Choe, K.O., et al. (2004) Pitfalls, artifacts and remedies in multi-detector row CT coronary angiography. Radiographics, 24, 787-800. doi:10.1148/rg.243035502
[19] Nakanishi, T., Kayashima, Y., Inoue, R., Sumii, K. and Gomyo, Y. (2005) Pitfalls in 16 detector row CT of the coronary arteries. Radiographics, 25, 425-440. doi:10.1148/rg.252045098
[20] Nieman, K., Rensing, B.J., van Geuns, R.J.M., et al. (2002) Non-invasive coronary angiography with multislice spiral computed tomography: Impact of heart rate. Heart, 88, 470-474. doi:10.1136/heart.88.5.470
[21] Giesler, T., Baum, U., Ropers, D., et al. (2002) Noninvasive visualization of coronary arteries using contrast-enhanced multidetector CT: Influence of heart rate on image quality and stenosis detection. American Journal of Roentgenology, 179, 911-916.
[22] Kaufmann, P.A., Camici, P.G. and Underwood, S.R. (2006) Nuclear cardiology. In: Camm, A.J., Luescher, T.F. and Serruys, P.W., Eds., The ESC Textbook of Cardiovascular Medicine, Blackwell Publishing Ltd., Oxford, 141-159.
[23] Zaret, B.L., Rigo, P., Wackers, F.J.T., et al. (1995) Myocardial perfusion imaging with Tc-99m tetrofosmin comparison to Tl-201 imaging and coronary angiography in a phase III multicenter trial. Circulation, 91, 313-319. doi:10.1161/01.CIR.91.2.313
[24] Geleijnse, M.L., Elhendy, A., Fioretti, P.M. and Roelandt, J.R.T.C. (2000) Dobutamine stress myocardial perfusion imaging. Journal of the American College of Cardiology, 36, 2017-2027. doi:10.1016/S0735-1097(00)01012-3
[25] Elhendy, A., van Domburg, R.T., Bax, J.J., et al. (1998) Noninvasive diagnosis of coronary artery stenosis in women with limited exercise capacity. Chest, 114, 1097- 1104. doi:10.1378/chest.114.4.1097
[26] Boomsma, M.M., Niemeyer, M.G., van der Wall, E.E., et al. (1998) Tc99m tetrofosmin myocardial SPECT perfusion imaging: comparison of rest-stress and stress-rest protocols. The International Journal of Cardiac Imaging, 14, 105-111. doi:10.1023/A:1005930200119
[27] Tamaki, N., Takahashi, N., Kawamoto, M., et al. (1994) Myocardial tomography using technetium-99m-tetrofosmin to evaluate coronary artery disease. Journal of Nuclear Medicine, 35, 594-600.
[28] Bai, J., Hashimoto, J., Suzuki, T., et al. (2001) Comparison of image reconstruction algorithms in myocardial perfusion scintigraphy. Annals of Nuclear Medicine, 15, 79-83. doi:10.1007/BF03012138
[29] Elhendy, A., van Domburg, R.T., Bax, J.J., Poldermans, D., Sozzi, F.B. and Roelandt, J.R.T.C. (2000) Accuracy of dobutamine technetium 99m sestamibi SPECT imaging for the diagnosis of single-vessel coronary artery disease: comparison with echocardiography. American Heart Journal, 139, 224-230.
[30] Elhendy, A., Bax, J.J. and Poldermans, D. (2002) Dobutamine stress myocardial perfusion imaging in coronary artery disease. Journal of Nuclear Medicine, 43, 1634-1646.
[31] Unlü, M. (2008) Myocardial perfusion scintigraphy in the diagnosis and prognostic assessment of coronary artery disease: SPET and PET. Anatolian Journal of Cardiology, 8, 5-11.
[32] Kang, X., Berman, D.S., Lewin, H.C., et al. (1999) Incremental prognostic value of myocardial perfusion single photon emission computed tomography in patients with diabetes mellitus. American Heart Journal, 138, 1025-1032. doi:10.1016/S0002-8703(99)70066-9

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.