Diagnostic and Interventional Radiology
Cardiovascular Imaging - Original Article

Role of DECT in coronary artery disease: a comparative study with ICA and SPECT

1.

Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Training and Research, Chandigarh, India

2.

Department of Cardiology, Postgraduate Institute of Medical Training and Research, Chandigarh, India

3.

Department of Nuclear Medicine, Postgraduate Institute of Medical Training and Research, Chandigarh, India

Diagn Interv Radiol 2020; 26: 420-428
DOI: 10.5152/dir.2020.18569
Read: 465 Downloads: 132 Published: 21 July 2020

PURPOSE

Earlier imaging techniques for coronary artery disease (CAD) focused primarily on either morphological or functional assessment of CAD. However, dual-energy computed tomography (DECT) can be used to assess myocardial blood supply both morphologically and functionally. We aimed to evaluate the diagnostic accuracy of DECT in detecting morphological and functional components of CAD, using invasive coronary angiography (ICA) and single photon emission computed tomography (SPECT) as reference standards.

 

METHODS

Twenty-five patients with known or suspicious CAD and scheduled for ICA were investigated by DECT and SPECT. DECT was performed during the resting state using retrospective electrocardiography (ECG) gating. CT coronary angiography and perfusion images were generated from the same raw data. All patients were evaluated for significant stenosis (≥50%) on both ICA and DECT coronary angiography, and for myocardial perfusion defects on SPECT and DECT perfusion. Comparison was done between ICA and DECT coronary angiography for detection of significant stenosis and between SPECT and DECT perfusion for detecting myocardial perfusion defects.

 

RESULTS

Using ICA as reference standard, sensitivity, specificity, and accuracy of DECT coronary angiography in detecting ≥50% stenosis of coronary artery lumen were 81.6%, 97.8%, and 95.0%, respectively, by segment-based analysis and 92.1%, 96.1%, and 93.7%, respectively, by vessel-based analysis. Using SPECT as the reference standard, the sensitivity, specificity, and accuracy of DECT perfusion in detecting myocardial perfusion defects were 70.4%, 86.4%, and 80.6%, respectively, on per-segment analysis and 90.7%, 66.6%, and 84.7%, respectively, on per-territorial basis.

 

CONCLUSION

DECT accurately detected coronary artery stenosis and myocardial ischemia using ICA and SPECT as reference standards. In the same scan, DECT can accurately provide integrative imaging of coronary artery morphology and myocardial perfusion.

 

You may cite this article as: Reddy KVP, Singhal M, Vijayvergiya R, Sood A, Khandelwal N. Role of DECT in coronary artery disease: a comparative study with ICA and SPECT. Diagn Interv Radiol 2020; 26:420–428

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