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. 2022 Jun 27;31(2):89-95.
doi: 10.4274/mirt.galenos.2022.00377.

Correlation of Morphological and Functional Cardiac Images: Fusion of Myocardial Perfusion SPECT and CT Angiography

Hüseyin Şan  1 , Alper Özgür Karaçalıoğlu  2 , Uğur Bozlar  3 , Semra İnce  2 , Engin Alagöz  2 , Mustafa Özdeş Emer  2 , Mustafa Taşar  3 , Nuri Arslan  2
Affiliations

Correlation of Morphological and Functional Cardiac Images: Fusion of Myocardial Perfusion SPECT and CT Angiography

Hüseyin Şan et al. Mol Imaging Radionucl Ther. .

Abstract
in English, Turkish

Objectives: The current study evaluates the value of cardiac hybrid imaging (CHI), performed by the fusion of functional and anatomic cardiac images, in the detection of hemodynamically significant coronary stenosis in cases with multiple coronary stenosis.

Methods: A total of 36 patients (10 female, 26 male) in whom ischemia or infarction was detected on gated myocardial perfusion single photon emission computed tomography (gMPS) and multiple coronary stenosis were concomitantly detected on coronary computed tomography angiography (CCTA) and undergone invasive coronary angiography (ICA) was included in this study. Statistical analyses were performed using SPSS 22 Windows software. McNemar test was applied to show concordance between coronary CT angiography, ICA and CHI in the detection of anatomically or hemodynamically significant stenosis in three major coronary arteries. Comparison results of coronary arteries responsible for perfusion defects on CHI and gMPS are presented as percentages (%).

Results: There was total accordance between coronary arteries leading to perfusion defects detected by gMPS and CHI in 50% of patients. It was observed a partial accordance in 36.1% of the patients. Additionally, it was also detected perfusion defects originated from side branches in 25% of the patients. Between results of CCTA and ICA, no statistically significant difference was noted in the detection of anatomically significant stenoses in the left main coronary artery, left anterior descending artery (LAD), left circumflex artery (LCx) and right coronary artery (RCA) (p=1.000, 0.070, 0.549, and 1.000, respectively). In addition, no statistically significant difference was found in the detection of anatomically and hemodynamically significant stenoses in LAD, LCx and RCA by CCTA and CHI (p=0.344, 0.629, and 0.219, respectively). No statistically significant difference was observed in the detection of anatomically and hemodynamically significant stenoses in LAD, LCx and RCA by ICA and CHI (p=0.804, 1.000, and 0.344, respectively).

Conclusion: It is possible to detect hemodynamically significant coronary stenosis directly by CHI modality in patients with multiple coronary stenosis, wide perfusion defects.

Amaç: Bu çalışmanın amacı, fonksiyonel ve anatomik kardiyak görüntülerin füzyonu ile gerçekleştirilen kardiyak hibrid görüntülemenin (KHG), multipl koroner darlıkları ve perfüzyon defektleri olan olgularda, hemodinamik olarak ciddi koroner darlıkları saptamadaki katkısını değerlendirmektir.

Yöntem: Çalışmaya gated miyokard perfüzyon sintigrafisi tek foton emisyonlu bilgisayarlı tomografi (gMPS) tetkikinde iskemi veya enfarkt ve koroner bilgisayarlı tomografi anjiyografi (KBTA) tetkikinde birden fazla koroner darlık saptanarak girişimsel koroner anjiyografi (GKA) yapılan toplam 36 hasta (10 kadın, 26 erkek) dahil edildi. Anatomik ve fonksiyonel görüntüler CardIQ Fusion yazılımı (GE Healthcare, IL, ABD) ile birleştirildi. İstatistiksel analizler SPSS 22 yazılımı kullanılarak yapıldı. Üç ana koroner arterde anatomik ve hemodinamik olarak ciddi koroner darlık tespitinde, KBTA, GKA ve KHG arasındaki uyumu göstermek için McNemar testi uygulandı. KHG ve gMPS’de perfüzyon defektlerinden sorumlu koroner arterlerin karşılaştırıldığı sonuçlar yüzde olarak sunuldu.

Bulgular: Hastaların %50’sinde, gMPS ve KHG ile perfüzyon defektlerinden sorumlu olduğu düşünülen koroner arterler arasında tam bir uyum vardı. Hastaların %36,1’inde kısmi uyum gözlenirken, %13,9’unda ise gMPS ile KHG tamamen uyumsuzdu. Hastaların %25’inde, KHG sayesinde, perfüzyon defektlerinden koroner yan dallardaki darlıkların sorumlu olduğu saptandı. Sol ana koroner arter, sol ön inen arter, sol sirkumfleks arter ve sağ koroner arterde anatomik olarak ciddi darlıkların saptanmasında; KBTA ve GKA sonuçları arasında istatistiksel olarak anlamlı bir fark saptanmadı (sırasıyla; p=1,000, 0,070, 0,549 ve 1,000). Ayrıca sol ön inen arter, sol sirkumfleks arter ve sağ koroner arterde; anatomik ve hemodinamik olarak ciddi darlıkların saptanmasında, KBTA ve KHG sonuçları arasında istatistiksel olarak anlamlı fark bulunmadı (sırasıyla; p=0,344, 0,629 ve 0,219). Ayrıca sol ön inen arter, sol sirkumfleks arter ve sağ koroner arterde; anatomik ve hemodinamik olarak ciddi darlıkların saptanmasında, GKA ve KHG arasında istatistiksel olarak anlamlı bir fark gözlenmedi (sırasıyla; p=0,804, 1,000 ve 0,344).

Sonuç: Multipl koroner darlıkları ve geniş perfüzyon defektleri olan hastalarda, KHG yöntemi ile iskemiden sorumlu olan, hemodinamik olarak ciddi koroner darlıkların doğrudan tespit edilmesi mümkündür.

Keywords: Cardiac hybrid imaging; coronary CT angiography; coronary stenosis; myocardial perfusion scintigraphy.

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1
gMPS and CHI findings a) gMPS polar map images; top: Stress perfusion, medium: Rest perfusion, bottom: Reversibility perfusion. b) Fusion image; normal perfusion areas at LAD vascularization zone. c) Fusion image; reversible perfusion defects at diagonal artery vascularization zone. d) Fusion image; fixed perfusion defects at RCA vascularization zone. e) CCTA image; severe calcified stenosis at diagonal artery. f) CCTA image; severe calcified stenosis at main body of RCA gMPS: Gated myocard perfusion scintigraphy, CHI: Cardiac hybrid imaging, LAD: Left anterior descending artery, RCA: Right coronary artery, CCTA: Coronary computed tomography angiography
Figure 2
Figure 2
gMPS and CHI findings a) gMPS polar map images; top: Stress perfusion, medium: Rest perfusion, bottom: Reversibility perfusion. b) Fusion image; hypoperfusion areas at 2nd and 3rd diagonal artery vascularization zone. c) Fusion image; perfusion defects at RCA vascularization zone. d) CCTA image; severe calcified stenosis at 3rd diagonal artery. e) CCTA image; severe calcified stenosis at 2nd diagonal artery. f) CCTA image; severe calcified stenosis at main body of RCA gMPS: Gated myocard perfusion scintigraphy, CHI: Cardiac hybrid imaging, LAD: Left anterior descending artery, RCA: Right coronary artery, CCTA: Coronary computed tomography angiography
Figure 3
Figure 3
gMPS and CHI findings a) gMPS polar map images; top: Stress perfusion, medium: Rest perfusion, bottom: Reversibility perfusion. b) Fusion image; normal perfusion areas of diagonal branch and LCx vascularization zone. c) Fusion image; partially reversible perfusion defects at LAD vascularization zone. d) Fusion image; wide perfusion defects at RCA vascularization zone. e) CCTA image; severe calcified stenosis at LAD. f) CCTA image; severe calcified and mixed type stenosis at main body of RCA gMPS: Gated myocard perfusion scintigraphy, CHI: Cardiac hybrid imaging, LCx: Left circumflex artery, LAD: Left anterior descending artery, RCA: Right coronary artery, CCTA: Coronary computed tomography angiography
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References

    1. Lee AK, Qutub MA, Aljizeeri A, Chow BJ. Integrating anatomical and functional imaging for the assessment of coronary artery disease. Expert Rev Cardiovasc Ther. 2013;11:1301–1310. - PubMed
    1. Roger VL, Go AS, Lloyd-Jones DM, Adams RJ, Berry JD, Brown TM, Carnethon MR, Dai S, de Simone G, Ford ES, Fox CS, Fullerton HJ, Gillespie C, Greenlund KJ, Hailpern SM, Heit JA, Ho PM, Howard VJ, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Makuc DM, Marcus GM, Marelli A, Matchar DB, McDermott MM, Meigs JB, Moy CS, Mozaffarian D, Mussolino ME, Nichol G, Paynter NP, Rosamond WD, Sorlie PD, Stafford RS, Turan TN, Turner MB, Wong ND, Wylie-Rosett J; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics--2011 update: a report from the American Heart Association. Circulation. 2011;123:e18–e209. - PMC - PubMed
    1. Shaw LJ, Berman DS, Maron DJ, Mancini GB, Hayes SW, Hartigan PM, Weintraub WS, O’Rourke RA, Dada M, Spertus JA, Chaitman BR, Friedman J, Slomka P, Heller GV, Germano G, Gosselin G, Berger P, Kostuk WJ, Schwartz RG, Knudtson M, Veledar E, Bates ER, McCallister B, Teo KK, Boden WE; COURAGE Investigators. Optimal medical therapy with or without percutaneous coronary intervention to reduce ischemic burden: results from the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial nuclear substudy. Circulation. 2008;117:1283–1291. - PubMed
    1. Tonino PA, Fearon WF, De Bruyne B, Oldroyd KG, Leesar MA, Ver Lee PN, Maccarthy PA, Van’t Veer M, Pijls NH. Angiographic versus functional severity of coronary artery stenoses in the FAME study fractional flow reserve versus angiography in multivessel evaluation. J Am Coll Cardiol. 2010;55:2816–2821. - PubMed
    1. Tonino PA, De Bruyne B, Pijls NH, Siebert U, Ikeno F, van’ t Veer M, Klauss V, Manoharan G, Engstrøm T, Oldroyd KG, Ver Lee PN, MacCarthy PA, Fearon WF; FAME Study Investigators. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention. N Engl J Med. 2009;360:213–224. - PubMed

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