Significant coronary artery stenosis assessment: diagnostic accuracy of quantitative 4D-MSPECT stress radionuclide myocardial perfusion imaging

Abstract

OBJECTIVES: The objective of this study was to evaluate the effectiveness of quantitative assessment of radionuclide myocardial perfusion imaging in indicating significant coronary artery stenosis. METHODS: Seven hundred and twenty patients with suspicion of coronary artery disease were retrospectively identified. All of them had undergone cardiac catheterization within the 6-month period after having one-day pharmacologic stress radionuclide myocardial perfusion scan. Important parameters were analyzed including myocardial perfusion, wall motion, wall thickening severity scores of 3 coronary artery territories and left ventricular ejection fraction values. These parameters were subsequently compared with the results of gold standard cardiac catheterization. RESULTS: Binary logistic regression analysis found that patients who had significant coronary artery stenosis had significantly higher value in all quantitative parameters (mean severity scores in myocardial perfusion, wall motion, wall thickening and left ventricular ejection fraction values in almost all 3 coronary artery territories) than those of the non-significant group (p-value <0.05) except wall motion severity score of the left circumflex artery. Similarly, higher perfusion severity scores had a greater probability of significant coronary artery stenosis in all 3 coronary arteries CONCLUSION: Quantitative parameters obtained from stress radionuclide myocardial perfusion imaging can indicate significant coronary artery stenosis in all 3 main coronary arteries on a level comparable with that of cardiac catheterization, which is the gold standard method. Higher perfusion severity scores indicated a greater probability of significant coronary artery stenosis.