The clinical value of myocardial perfusion imaging and coronary artery calcification with fusion imaging by acquisition by SPECT/CT in detection of coronary artery disease in elderly patients

Abstract

Objective To investigate the clinical value of myocardial perfusion imaging (MPI) and coronary artery calcification (CAC) with one-stop-shop acquisition by SPECT/CT in detection of coronary artery disease (CAD) in elderly patients. Methods The 133 patients with suspected or diagnosed CAD who underwent gated MPI and CAC scan by SPECT/CT during October 2012 to December 2012 were prospectively studied. All patients were divided into elderly group (aged ≥60 years) and non-elderly group (aged<60 years), normal MPI group and abnormal MPI group, and 0, 1-9, 10-99, 100-399, ≥400 subgroups according to CAC scores (CACS). Mann-Whitney U test, Kruskal-Wallis one-way AVOVA test, χ2 test, Fisher's exact test were performed for statistical analysis. Results CAC positive rate and CACS were higher in normal MPI group than in abnormal MPI group 〔72.6% (69/95) vs. 52.6% (20/38), (386.8±815.0)scores vs. (56.5±109.0)scores, P 0.05). The sensitivity, specificity and accuracy of CAC in detection of myocardial ischemia or infarction were 72.6% (69/95), 47.4% (18/38), 65.4% (87/133), respectively. The CACS was higher in elderly group than in non-elderly group〔(356.7±790.0)scores vs. (89.7±233.0)scores, P 0.05〕. Conclusions One-stop-shop acquisition of MPI and CAC by SPECT/CT is convenient. MPI-CAC SPECT/CT may offer comprehensive information on both myocardial perfusion and CAC and provide a better information platform for the accurate exploration of myocardial ischemia and infarction in clinic, especially for the elderly patients. However, due to usually more severe CAC in elderly patients, we should enhance the diagnostic cutoff score in order to obtain a higher diagnostic specificity of MPI-CAC. Key words: Tomography, emission-computed, single-photon; Myocardial perfusion imaging; Fractional flow reserve, myocardial; Coronary disease