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. 2012 Dec;9(4):349-54.
doi: 10.3724/SP.J.1263.2012.06291.

A head-to-head comparison of the coronary calcium score by computed tomography with myocardial perfusion imaging in predicting coronary artery disease

Mansour Almoudi  1 , Zhong-Hua Sun
Affiliations

A head-to-head comparison of the coronary calcium score by computed tomography with myocardial perfusion imaging in predicting coronary artery disease

Mansour Almoudi et al. J Geriatr Cardiol. 2012 Dec.

Abstract

Objectives: The coronary artery calcium (CAC) score has been shown to predict future cardiac events. However the extent to which the added value of a CAC score to the diagnostic performance of myocardial perfusion imaging (MPI) by single photon emission computed tomography (SPECT) is unclear. The purpose of this study is to investigate the correlation between CAC score and SPECT in patients with suspected coronary artery disease.

Methods: A retrospective review of the CAC scores by use of the Agatston calcium scoring method and cardiac SPECT diagnostic reports was conducted in 48 patients, who underwent both coronary computed tomography (CT) and SPECT examinations due to suspected coronary artery disease. A Pearson correlation test was used to determine the relation between CAC scores and MPI-SPECT assessments with regard to the evaluation of the extent of disease.

Results: Forty-seven percent of the patients had CAC scores more than 100, while 42% of these patients demonstrated abnormal, or probably abnormal, MPI-SPECT. Of the 23% of patients with a zero CAC score, only 7% had normal MPI-SPECT findings. No significant correlation was found between the CAC scores and MPI-SPECT assessments (r value ranged from 0.012 to 0.080), regardless of the degree of coronary calcification.

Conclusions: There is a lack of correlation between the CAC scores and the MPI-SPECT findings in the assessment of the extent of coronary artery disease. CAC scores and MPI-SPECT should be considered complementary approaches in the evaluation of patients with suspected coronary artery disease.

Keywords: Coronary artery disease; Coronary calcium score; Coronary computed tomography; Myocardial perfusion imaging.

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Figures

Figure 1.
Figure 1.. Distribution of the CAC scores with myocardial perfusion imaging among the 48 patients with suspected coronary artery disease.
As shown in the figure, there is a significant discordance between the CAC and MPI-SPECT score, with abnormal SPECT scores (range from 1 to 4) noticed in 10 patients with a zero CAC. CAC: coronary artery calcium; MPI-SPECT: myocardial perfusion imaging with gated single photon emission computed tomography.
Figure 2.
Figure 2.. Graph shows that there is a lack of correlation between coronary artery calcium scores and the corresponding myocardial perfusion SPECT assessments, with r value of 0.019.
CAC: coronary artery calcium; MPI-SPECT: myocardial perfusion imaging with gated single photon emission computed tomography (SPECT).
See this image and copyright information in PMC

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