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Updated: Apr 16, 2026
High-Resolution Cardiac Positron Emission Tomography/Computed Tomography for Small Animals
Published on: December 16, 2022
A randomized, multicenter, multivendor study of myocardial perfusion imaging with regadenoson CT perfusion vs single
Ricardo C Cury1, Therese M Kitt2, Kathleen Feaheny3
1Department of Radiology, Baptist Hospital of Miami, 8900 North Kendall Drive, Miami, FL 33176, USA; Miami Cardiac and Vascular Institute, Miami, FL, USA.
Insights
Regadenoson CT perfusion (CTP) is as effective as SPECT for detecting myocardial ischemia. This study confirms regadenoson CTP
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Myocardial CT perfusion (CTP) shows promise for detecting myocardial ischemia.
- Regadenoson CTP is being investigated as a potential alternative to SPECT.
Purpose of the Study:
- To test the hypothesis that regadenoson CTP is noninferior to regadenoson SPECT in detecting or excluding myocardial ischemia.
Main Methods:
- 124 patients with suspected coronary artery disease were randomized to CTP or SPECT first.
- Diagnostic sequences involved rest and regadenoson stress imaging.
- Primary analysis focused on agreement between CTP and SPECT for ischemia detection.
Main Results:
- Regadenoson CTP demonstrated noninferiority to SPECT, with an agreement rate of 0.87.
- CTP showed a sensitivity of 0.90 and specificity of 0.84 for detecting reversible ischemia.
- Agreement for fixed defects was 0.86; CTP diagnostic accuracy was 0.85 compared to SPECT.
Conclusions:
- Regadenoson CTP is noninferior to regadenoson SPECT for diagnosing myocardial ischemia.
- CTP offers a viable alternative for assessing myocardial perfusion.
Background:
Myocardial CT perfusion (CTP) is a promising tool for the detection of myocardial ischemia. We hypothesize that regadenoson CTP is noninferior to regadenoson single photon emission CT (SPECT) for detecting or excluding myocardial ischemia.
Methods:
Patients (men ≥ 45 years; women ≥ 50 years) with known or suspected coronary artery disease (n = 124) were randomized to 1 of 2 diagnostic sequences: rest and regadenoson SPECT on day 1, then regadenoson CTP and rest CTP (and coronary CT angiography [CTA]) (CTA; same acquisition) on day 2 or regadenoson CTP and rest CTP (and CTA) on Day 1, then rest and regadenoson SPECT on day 2. Scanning platforms included 64-, 128-, 256-, and 320-slice systems. The primary analysis examined the agreement rate between CTP and SPECT for detecting or excluding reversible ischemia in ≥ 2 myocardial segments as assessed by independent, blinded readers.
Results:
Complete and interpretable CTP and SPECT scans were obtained for 110 patients. Regadenoson CTP was noninferior to SPECT for detecting or excluding reversible ischemia with an agreement rate of 0.87 (95% confidence interval [CI], 0.77-0.97) and sensitivity and specificity of 0.90 (95% CI, 0.71-1.00) and 0.84 (95% CI, 0.77-0.91), respectively. The agreement rate for detecting or excluding ≥ 1 fixed defects by regadenoson CTP and SPECT was 0.86 (95% CI, 0.74-0.98). With SPECT as the reference standard, the diagnostic accuracies for detecting or excluding ischemia by regadenoson CTP and CTA alone were 0.85 (95% CI, 0.78-0.91) and 0.69 (95% CI, 0.60-0.77), respectively.
Conclusions:
This study establishes the noninferiority of regadenoson CTP to SPECT for detecting or excluding myocardial ischemia.
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