Related Experiment Video
Updated: May 5, 2026
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Cardiac positron emission tomography/computed tomography imaging accurately detects anatomically and functionally
S Kajander1, E Joutsiniemi, M Saraste
1Turku PET Centre, Turku, Finland.
Insights
Hybrid positron emission tomography (PET)/CT accurately detects coronary artery disease. This noninvasive imaging method combines CT angiography and perfusion imaging for improved diagnostic accuracy with low radiation doses.
Area of Science:
- Cardiology
- Radiology
- Nuclear Medicine
Background:
- Computed tomography (CT) is widely used for coronary artery disease (CAD) detection, but stenosis evaluation can be uncertain.
- Perfusion imaging is crucial for identifying ischemia and guiding treatment.
- Hybrid positron emission tomography (PET)/CT offers combined angiography and perfusion imaging in efficient, quantitative, low-dose protocols.
Purpose of the Study:
- To evaluate the accuracy of cardiac hybrid PET/CT for noninvasive detection of coronary artery disease.
- To compare the diagnostic performance of hybrid PET/CT with CT angiography and perfusion imaging alone against invasive angiography.
Main Methods:
- 107 patients with intermediate pretest likelihood of CAD underwent quantitative PET/(15)O-water and CT angiography using hybrid PET/CT.
- Results were validated against invasive angiography, including fractional flow reserve measurements where applicable.
- Radiation doses for prospective triggering and spiral CT protocols were recorded.
Main Results:
- Hybrid PET/CT achieved 98% accuracy in detecting coronary artery disease, significantly outperforming CT angiography alone (81% PPV) and perfusion imaging alone.
- Both PET/CT and CT angiography showed a 97% negative predictive value.
- Radiation doses were low, with a mean of 9.3 mSv for prospective triggering protocols.
Conclusions:
- Cardiac hybrid PET/CT provides accurate noninvasive diagnosis of coronary artery disease in symptomatic individuals.
- The imaging modality is feasible for routine clinical use.
- Most patients can undergo the procedure with less than 10 mSv radiation exposure.
Background:
Computed tomography (CT) is increasingly used to detect coronary artery disease, but the evaluation of stenoses is often uncertain. Perfusion imaging has an established role in detecting ischemia and guiding therapy. Hybrid positron emission tomography (PET)/CT allows combination angiography and perfusion imaging in short, quantitative, low-radiation-dose protocols.
Methods And Results:
We enrolled 107 patients with an intermediate (30% to 70%) pretest likelihood of coronary artery disease. All patients underwent PET/CT (quantitative PET with (15)O-water and CT angiography), and the results were compared with the gold standard, invasive angiography, including measurement of fractional flow reserve when appropriate. Although PET and CT angiography alone both demonstrated 97% negative predictive value, CT angiography alone was suboptimal in assessing the severity of stenosis (positive predictive value, 81%). Perfusion imaging alone could not always separate microvascular disease from epicardial stenoses, but hybrid PET/CT significantly improved this accuracy to 98%. The radiation dose of the combined PET and CT protocols was 9.3 mSv (86 patients) with prospective triggering and 21.8 mSv (21 patients) with spiral CT.
Conclusions:
Cardiac hybrid PET/CT imaging allows accurate noninvasive detection of coronary artery disease in a symptomatic population. The method is feasible and can be performed routinely with <10 mSv in most patients.
Clinical Trial Registration:
URL: http://www.clinicaltrials.gov. Unique identifier: NCT00627172.
More Related Videos
Related Concept Videos
01:10Computed Tomography
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
01:29Positron Emission Tomography
One of the main requirements of a PET scan is a positron-emitting radioisotope, which is produced in a cyclotron and then attached to a substance used by the part of the body...
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:28Imaging Studies for Cardiovascular System V: CT
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:30Acute Coronary Syndrome III: Diagnostic Studies