Advantage of the Use of Spect/Ct and Calcium Score in a Single Device for the Diagnosis of the Atherosclerotic Coronary Disease

The aim was to investigate the efficacy of concomitant CAC score acquisition and gated single-photon emission computed tomography myocardial perfusion imaging (SPECT) for the assessment of CAD..

101 consecutive patients referred for investigation of CAD. Data was acquired using the Discovery NM/CT 670 CZT system and analyzed. This consistied of SPECT/CT (16-slice) and patient data acquisition by nuclear medicine Stress/Rest MIBI. CAC was measured with Agatston calcium scoring.. Our results were assessed by Mann-Whitney nonparametric testing and Pearson chi-square test.

Positive CAC scores (>400) were obtained in 52%. Positive SPECT scans in 16% and 43% of patients were given a positive score based on clinical history. A significant (p<0.05) association between CAC score and SPECT was observed. Positive SPECT testing was associated (p<0.05) with a higher calcium score compared to negative SPECT. Higher calcium scores were associated to positive clinical history patients (p<0.0001). Though the sensitivity of CAC score was low (65%), its negative predictive value was high at 87%.

The prognostic value, as well as the cost/benefit ratio of this combined technique need to be further evaluated. We believe that the ease of handling, the short operational time and short radiation exposure make this technique a promising tool for the ‘one-stop’ evaluation of CAD.