Impact of scan quality on the diagnostic performance of CCTA, SPECT, and PET for diagnosing myocardial ischemia defined by fractional flow reserve.
J Cardiovasc Comput Tomogr
; 14(1): 60-67, 2020.
Article
em En
| MEDLINE
| ID: mdl-31302028
ABSTRACT
BACKGROUND:
Scan quality can have a significant effect on the diagnostic performance of non-invasive imaging techniques. However, the extent of its influence has scarcely been investigated in a head-to-head manner.METHODS:
Two-hundred and eight patients underwent CCTA, SPECT, and PET prior to invasive fractional flow reserve measurements. Scan quality was classified as either good, moderate, or poor.RESULTS:
Distribution of good, moderate, and poor quality scans was; CCTA; 66%, 22%, 13%; SPECT; 52%, 38%, 9%; PET; 86%, 13%, 1%. Good quality CCTA scans possessed a higher specificity (75% vs. 31%, pâ¯=â¯0.001), positive predictive value (PPV, 71% vs. 51%, pâ¯=â¯0.050), and accuracy (80% vs. 60%, pâ¯=â¯0.009) compared to moderate quality scans, while sensitivity (94%) and negative predictive value (NPV, 88%) were similar to moderate and poor quality scans. Sensitivity (76%), NPV (84%), and accuracy (85%) of good quality SPECT scans was superior to those of moderate (41% pâ¯=â¯0.001, 56% pâ¯=â¯0.010, 70% pâ¯=â¯0.010) and poor quality (30% pâ¯=â¯0.003, 65% pâ¯=â¯0.069, 63% pâ¯=â¯0.038). Specificity (92%) and PPV (87%) of good quality SPECT scans did not differ from scans of diminished quality. Good quality PET scans exhibited high sensitivity (84%), specificity (86%), NPV (88%), PPV (81%) and accuracy (85%), which was comparable to scans of lesser quality. Good quality CCTA, SPECT, and PET scans demonstrated a similar diagnostic accuracy (pâ¯=â¯0.247).CONCLUSION:
Diagnostic performance of CCTA, and SPECT is hampered by scan quality, while the diagnostic value of PET is not affected. Good quality CCTA, SPECT, and PET scans possess a high diagnostic accuracy.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Tomografia Computadorizada de Emissão de Fóton Único
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Angiografia Coronária
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Isquemia Miocárdica
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Reserva Fracionada de Fluxo Miocárdico
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Imagem de Perfusão do Miocárdio
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Tomografia Computadorizada Multidetectores
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Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada
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Angiografia por Tomografia Computadorizada
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article