Benefits of adding coronary calcium score scan to stress myocardial perfusion positron emission tomography imaging
There have been little and conflicting data regarding the relationship between coronary artery calcification score (CACS) and myocardial ischemia on positron emission tomography myocardial perfusion imaging (PET MPI). The aims of this study were to investigate the relationship between myocardial isc...
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| Format: | Article |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2019-01-01
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| Series: | World Journal of Nuclear Medicine |
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| Online Access: | http://www.wjnm.org/article.asp?issn=1450-1147;year=2019;volume=18;issue=2;spage=149;epage=153;aulast=Fathala |
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| author | Ahmed Fathala Mervat Aboulkheir Salwa Bukhari Mohamed M Shoukri Moheieldin M Abouzied |
| author_facet | Ahmed Fathala Mervat Aboulkheir Salwa Bukhari Mohamed M Shoukri Moheieldin M Abouzied |
| author_sort | Ahmed Fathala |
| collection | DOAJ |
| description | There have been little and conflicting data regarding the relationship between coronary artery calcification score (CACS) and myocardial ischemia on positron emission tomography myocardial perfusion imaging (PET MPI). The aims of this study were to investigate the relationship between myocardial ischemia on PET MPI and CACS, the frequency and severity of CACS in patients with normal PET MPI, and to determine the optimal CACS cutoff point for abnormal PET. This retrospective study included 363 patients who underwent same-setting stress PET perfusion imaging and CACS scan because of clinically suspected coronary artery disease (CAD). Fifty-five (55%) of the 363 patients had abnormal PET perfusion. There was an association between sex, diabetes mellitus (DM), smoking, and CACS and PET perfusion abnormities with P = 0.003, 0.05, 0.005, and 0.001, respectively. However, there was no association between PET perfusion abnormalities with age, body mass index, hypertension, and hypercholesterolemia. There was association between CACS and age, sex, and DM with P = 0.000, 0.014, and 0.052, respectively, and stepwise increase in the frequency of myocardial ischemia and CACS groups. Receiver-operating characteristic analysis showed that a CACS ≥304 is the optimal cutoff for predicting perfusion abnormalities with sensitivity of 64% and specificity of 69%. In conclusion, the frequency of CAC in patients with normal PET MPI is 49%, it is highly recommended to combine CACS with PET MPI in patients without a history of CAD. PET MPI identifies myocardial ischemia and defines the need for coronary revascularization, but CAC reflects the anatomic burden of coronary atherosclerosis. Combining CACS to PET MPI allows better risk stratification and identifies high-risk patients with PET, and it may change future follow-up recommendations. CACS scan is readily available and easily acquired with modern PET-computed tomography (CT) and single-photon emission CT (SPECT)-CT with modest radiation exposure. |
| format | Article |
| id | doaj-art-f68712a162704d82b61c78e7e00fe6f8 |
| institution | Kabale University |
| issn | 1450-1147 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | World Journal of Nuclear Medicine |
| spelling | doaj-art-f68712a162704d82b61c78e7e00fe6f82025-08-20T03:48:32ZengThieme Medical and Scientific Publishers Pvt. Ltd.World Journal of Nuclear Medicine1450-11472019-01-0118214915310.4103/wjnm.WJNM_34_18Benefits of adding coronary calcium score scan to stress myocardial perfusion positron emission tomography imagingAhmed FathalaMervat AboulkheirSalwa BukhariMohamed M ShoukriMoheieldin M AbouziedThere have been little and conflicting data regarding the relationship between coronary artery calcification score (CACS) and myocardial ischemia on positron emission tomography myocardial perfusion imaging (PET MPI). The aims of this study were to investigate the relationship between myocardial ischemia on PET MPI and CACS, the frequency and severity of CACS in patients with normal PET MPI, and to determine the optimal CACS cutoff point for abnormal PET. This retrospective study included 363 patients who underwent same-setting stress PET perfusion imaging and CACS scan because of clinically suspected coronary artery disease (CAD). Fifty-five (55%) of the 363 patients had abnormal PET perfusion. There was an association between sex, diabetes mellitus (DM), smoking, and CACS and PET perfusion abnormities with P = 0.003, 0.05, 0.005, and 0.001, respectively. However, there was no association between PET perfusion abnormalities with age, body mass index, hypertension, and hypercholesterolemia. There was association between CACS and age, sex, and DM with P = 0.000, 0.014, and 0.052, respectively, and stepwise increase in the frequency of myocardial ischemia and CACS groups. Receiver-operating characteristic analysis showed that a CACS ≥304 is the optimal cutoff for predicting perfusion abnormalities with sensitivity of 64% and specificity of 69%. In conclusion, the frequency of CAC in patients with normal PET MPI is 49%, it is highly recommended to combine CACS with PET MPI in patients without a history of CAD. PET MPI identifies myocardial ischemia and defines the need for coronary revascularization, but CAC reflects the anatomic burden of coronary atherosclerosis. Combining CACS to PET MPI allows better risk stratification and identifies high-risk patients with PET, and it may change future follow-up recommendations. CACS scan is readily available and easily acquired with modern PET-computed tomography (CT) and single-photon emission CT (SPECT)-CT with modest radiation exposure.http://www.wjnm.org/article.asp?issn=1450-1147;year=2019;volume=18;issue=2;spage=149;epage=153;aulast=FathalaCoronary artery calcification score-coronary artery diseasemyocardial ischemiapositron emission tomography myocardial perfusionstress functional imaging |
| spellingShingle | Ahmed Fathala Mervat Aboulkheir Salwa Bukhari Mohamed M Shoukri Moheieldin M Abouzied Benefits of adding coronary calcium score scan to stress myocardial perfusion positron emission tomography imaging World Journal of Nuclear Medicine Coronary artery calcification score-coronary artery disease myocardial ischemia positron emission tomography myocardial perfusion stress functional imaging |
| title | Benefits of adding coronary calcium score scan to stress myocardial perfusion positron emission tomography imaging |
| title_full | Benefits of adding coronary calcium score scan to stress myocardial perfusion positron emission tomography imaging |
| title_fullStr | Benefits of adding coronary calcium score scan to stress myocardial perfusion positron emission tomography imaging |
| title_full_unstemmed | Benefits of adding coronary calcium score scan to stress myocardial perfusion positron emission tomography imaging |
| title_short | Benefits of adding coronary calcium score scan to stress myocardial perfusion positron emission tomography imaging |
| title_sort | benefits of adding coronary calcium score scan to stress myocardial perfusion positron emission tomography imaging |
| topic | Coronary artery calcification score-coronary artery disease myocardial ischemia positron emission tomography myocardial perfusion stress functional imaging |
| url | http://www.wjnm.org/article.asp?issn=1450-1147;year=2019;volume=18;issue=2;spage=149;epage=153;aulast=Fathala |
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