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Myocardial Perfusion Imaging Versus Coronary CT Angiography for the Detection of Coronary Artery Disease
Farnaz Fariba1,2, Seyed Kamaledin Hadei1, Hossein ForughiMoghadam3
1Cardiovascular Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
Insights
Coronary artery disease (CAD) diagnosis using coronary CT angiography (CCTA) showed higher accuracy and sensitivity than myocardial perfusion imaging (MPI). Both CCTA and MPI offer complementary information for comprehensive CAD assessment.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Medical Technology
Background:
- Early diagnosis of coronary artery disease (CAD) is crucial for preventing complications.
- Non-invasive imaging tests like myocardial perfusion imaging (MPI) and coronary CT angiography (CCTA) are vital for CAD diagnosis.
Purpose of the Study:
- To compare the diagnostic performance of MPI and CCTA in patients with suspected CAD.
- To evaluate the accuracy, sensitivity, and specificity of MPI and CCTA against invasive coronary angiography (ICA).
Main Methods:
- A cross-sectional study involving 51 patients who underwent both MPI and CCTA.
- 18 high-risk patients with positive non-invasive tests proceeded to invasive coronary angiography (ICA) for comparison.
- Data analysis included descriptive statistics, t-tests, chi-square tests, and ROC curve analysis using SPSS version 21.
Main Results:
- Coronary CT angiography (CCTA) demonstrated higher sensitivity (100% vs. 88%), specificity (33% vs. 0%), and accuracy (66% vs. 44%) compared to myocardial perfusion imaging (MPI).
- CCTA also showed a higher positive predictive value (60% vs. 47%) than MPI.
- The diagnostic accuracy of MPI was considered relatively good (Area under ROC curve = 0.691), with potential utility in functional evaluation and moderate stenosis.
Conclusions:
- Coronary CT angiography (CCTA) offers superior sensitivity and accuracy for CAD detection compared to MPI.
- CCTA and MPI provide distinct, complementary information, suggesting their use is supplemental rather than substitutional in CAD assessment.
Background:
Considering the importance of early diagnosis of coronary artery disease (CAD) in reducing subsequent complications, non-invasive tests, especially myocardial perfusion imaging (MPI) and coronary CT angiography (CCTA) play a pivotal role in this regard. Therefore, a study was conducted to compare the diagnostic results of these two methods.
Methods:
A cross-sectional study was conducted on 51 patients who underwent MPI and CCTA and 18 patients whose noninvasive test was positive and high risk underwent invasive coronary angiography (ICA) at Farshchian Heart Center, Hamadan, Iran, during one year (2019-2020). The data including demographic characteristics as well as the histories of dyslipidemia, smoking, positive family history, hypertension, and diabetes, was collected using a checklist. Descriptive statistics, independent samples t-tests, and chi-square tests and Sensitivity, Specificity and Positive predictive value, Negative predictive value and Roc Curve were applied for data analysis. For data analysis, the SPSS software version 21 was used. P values less than 0.05 were considered.
Results:
The mean age of the patients, including 29 males (56.9%) and 22 females (43.1%), was 60.11±8.99 years. No significant correlation was found between the results of MPI and CCTA compared to ICA. CCTA demonstrated higher sensitivity (100% versus 88%), higher specificity (33% versus 0%), and higher accuracy (66% versus 44%) than MPI. Furthermore, CCTA performed better in terms of positive predictive value (60% versus 47%) than MPI. The overall diagnostic accuracy of MPI when CCTA is considered as a reference, according to the area under the Rock's curve, which is equal to 0.691, is relatively good. Based on the calculated optimal Yoden index, the appropriate cut point is SSS≥8. on the other hand, MPI can be useful in functional evaluation and has important rules in moderate stenosis.
Conclusion:
Considering the high sensitivity and accuracy of CCTA compared to MPI, CTCA, and MPI provide differing information for CAD from respective angles. The correlation between CTCA and MPI is supplemental rather than substitutional.
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