Resting Cardiac 64-MDCT Does Not Reliably Detect Myocardial Ischemia Identified by Radionuclide Imaging

OBJECTIVES: CT myocardial perfusion imaging is an emerging diagnostic modality that is under intensive study but not yet widely used in clinical practice. The purpose of this study is to evaluate (392/520) in systole, and a sensitivity of 18% (27/152), specificity of 89% (382/428), positive predictive value of 37% (27/73), and negative predictive value of 75% (382/507) in diastole, as compared with MPI. There was no significant difference in subendocardial perfusion between ischemic and nonischemic segments by the automated method. There was no significant difference in CT perfusion between patients with and without obstructive coronary artery disease on CT angiography using the visual or automated methods.

CONCLUSIONS: Resting 64-MDCT is unsuitable for clinical use in revealing ischemia seen on MPI. Kayvon Webster Womens Jersey

PMID: 23345355

Posted in Nuclear Imaging and tagged , , .

3 Comments

  1. I agree with you Paul. From the paper: “It has been hypothesized that the higher spatial resolution of CT may detect small areas of differential blood flow even without stress stimuli.” But I agree that the paper doesn’t say much!

  2. There may be a value in finding hypodense subendocardial segments on resting CTA of the heart as it MOST likely represents areas of old infarcts that underwent fibrofatty replacement/scarring. It would be more important to know to differentiate those areas as old infarcts than as areas of true ischemia from hypoperfusion.

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