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Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-14225

Husmann, L; Herzog, B A; Gaemperli, O; Tatsugami, F; Burkhard, N; Valenta, I; Veit-Haibach, P; Wyss, M T; Landmesser, U; Kaufmann, P A (2009). Diagnostic accuracy of computed tomography coronary angiography and evaluation of stress-only single-photon emission computed tomography/computed tomography hybrid imaging: comparison of prospective electrocardiogram-triggering vs. retrospective gating. European Heart Journal, 30(5):600-607.

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Aims To determine diagnostic accuracy, effective radiation dose, and potential value of computed tomography coronary angiography (CTCA) for hybrid imaging with single-photon emission computed tomography (SPECT) comparing prospective electrocardiogram (ECG)-triggering vs. retrospective ECG-gating. Methods and results Two hundred patients underwent standard myocardial stress/rest- SPECT perfusion imaging, which served as standard of reference. One hundred consecutive patients underwent 64-slice CTCA using prospective ECG-gating, and were compared with 100 patients who had previously undergone CTCA using retrospective ECG-gating. For predicting ischaemia, CTCA with prospective ECG-triggering and a stenosis cut-off >50% had a per-vessel sensitivity, specificity, negative, and positive predictive value of 100, 84, 100, and 30%; respective values for CTCA with retrospective ECG-gating were similar (P = n.s.): 86, 83, 98, and 33%. Combining CTCA with stress-only SPECT revealed 100% clinical agreement with regard to perfusion defects, and provided additional information in half the patients on preclinical coronary findings. Effective radiation dose was 2.2 +/- 0.7 mSv for CTCA with prospective ECG-triggering, and 19.7 +/- 4.2 mSv with retrospective ECG-gating (P < 0.001) (5.4 +/- 0.8 vs. 24.1 +/- 4.3 mSv for hybrid imaging). Conclusion Prospective ECG-triggering for CTCA reduces radiation dose by almost 90% without affecting diagnostic performance. Combined imaging with stress-only SPECT is an attractive alternative to standard stress/rest-SPECT for evaluation of coronary artery disease, offering additional information on preclinical atherosclerosis.


58 citations in Web of Science®
66 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Nuclear Medicine
Dewey Decimal Classification:610 Medicine & health
Date:23 March 2009
Deposited On:26 Feb 2009 09:00
Last Modified:05 Apr 2016 13:02
Publisher:Oxford University Press
Additional Information:This is a pre-copy-editing, author-produced PDF of an article accepted for publication in European Heart Journal following peer review. The definitive publisher-authenticated version European Heart Journal 2009 30(5):600-607; doi:10.1093/eurheartj/ehn536 is available online at: http://eurheartj.oxfordjournals.org/cgi/content/abstract/30/5/600
Publisher DOI:10.1093/eurheartj/ehn536
PubMed ID:19106197

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