A comparative study of electron beam CT and myocardial perfusion imaging in assessment of coronary artery disease

Purpose: To compare coronary artery calcification (CAC) detected by electron beam CT (EBCT) with myocardial perfusion imaging (MPI) performed by SPECT in assessment of coronary artery disease (CAD). Materials and methods: Fifty consecutive patients with suspected or documented CAD were studied. All of them underwent EBCT, 99mTc-MIBI SPECT (stress-rest) as well as coronary angiography. Results: Forty patients with 84 involved vessels were angiographically proved to have CAD (>50% stenosis) (14 patients with single, 8 with double and 18 with triple vessels disease) while 10 patients had normal coronary angiography. The sensitivity, specificity and accuracy of CAC on EBCT for predicting CAD was 83%, 80% and 82% while that of MPI was 85%, 80% and 84% respectively. Ischemia was shown in 65% of myocardial segments supplied by the calcified coronary arteries. Conclusion: Detection of CAC with EBCT is a valuable method in assessment of CAD. In symptomatic population, the majority of patients with CAC had myocardial ischemia that was proved by MPI, therefore screening for CAC should be carried out in asymptomatic population in order to detect CAD at early stage