Hybrid SPECT/CT Imaging in the Evaluation of Coronary Stenosis: Role in Diabetic Patients.

Andrea Romagnoli,Giovanni Simonetti,Ferdinando Calabria,Aurora Ricci,Chiara Arganini,Sonia Crusco,Massimiliano Sperandio,Eleonora Gaspari,Irene Coco,Orazio Schillaci,Daniele Morosetti

doi:10.5402/2013/419737

Andrea Romagnoli, Giovanni Simonetti + Show 9 more

Open Access

https://doi.org/10.5402/2013/419737

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Abstract

Purpose. Our purpose was to combine the results of the MDCT (multidetector computed tomography) morphological data and the SPECT (single-photon emission computed tomography) data using hybrid imaging to overcome the limits of the MDCT in the evaluation of coronary stenosis in diabetic patients with large amount of calcium in the coronary arteries. Method and Materials. 120 diabetic patients underwent MDCT examination and SPECT examination. We evaluated 324 coronary arteries. After the examinations, we merged CT and SPECT images. Results. CT evaluation: 52 (32.8%) coronaries with stenosis ≥ 50%, 228 (70.4%) with stenosis < 50%, and 44 (13.6%) with a doubtful evaluation. SPECT evaluation: 80 (24.7%) areas with hypoperfusion, 232 (71.6%) with normal perfusion, and 12 (3.7%) with a doubtful evaluation. Of 324 coronary arteries and corresponding areas, the hybrid SPECT/CT evaluation showed 92 (28.4%) areas with hypoperfusion, and 232 (71.6%) with normal perfusion. Conclusion. Hybrid CT/SPECT imaging could be useful in the detection of significant coronary stenosis in patients with large amount of coronary calcifications.

Highlights

Diabetes mellitus type 2 is strictly related to CAD; 70–80% of diabetic patients die of cardiovascular complications; these patients have a risk of myocardial infarction about four times higher than that found in the general population [1,2,3]. erefore, the early detection of CAD in diabetic patients is very important.Several noninvasive techniques are available for this purpose, including stress ECG and singlephoton emission computed tomography (SPECT) [4, 5] and most recently coronary CT
Our purpose was to combine the results of the MDCT morphological data and the SPECT data using hybrid imaging to overcome the limits of the MDCT in the evaluation of coronary stenosis in diabetic patients with large amount of calcium in the coronary arteries
Myocardial perfusion scintigraphy represents the most widely used technique validated in the prognostic strati cation of diabetic patients with known or suspected ischemic heart disease in order to predict the short and medium terms for cardiac events such death and myocardial infarction [18, 19]

Summary

Introduction

Diabetes mellitus type 2 is strictly related to CAD (coronary artery disease); 70–80% of diabetic patients die of cardiovascular complications; these patients have a risk of myocardial infarction about four times higher than that found in the general population [1,2,3]. erefore, the early detection of CAD in diabetic patients is very important.Several noninvasive techniques are available for this purpose, including stress ECG and SPECT (single photon emission computed tomography) [4, 5] and most recently coronary CT. In case of important coronary calci cations, the CT examination presents several limitations in residual vessel lumen evaluation [12]. It is well known that diabetes causes a large amount of vessel calci cation, resulting in lower diagnostic accuracy of CT in the detection and evaluation of coronary stenosis in diabetic patients [13]. In this case, it could be useful to work with hybrid imaging, merging the anatomical images of CT to the functional images of SPECT, overcoming the limits of the two techniques

Methods

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Conclusion