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Title:

Multicentre multi-device hybrid imaging study of coronary artery disease: results from the EValuation of INtegrated Cardiac Imaging for the Detection and Characterization of Ischaemic Heart Disease (EVINCI) hybrid imaging population.

Document type:
Journal Article
Author(s):
Liga, Riccardo; Vontobel, Jan; Rovai, Daniele; Marinelli, Martina; Caselli, Chiara; Pietilä, Mikko; Teresinska, Anna; Aguadé-Bruix, Santiago; Pizzi, Maria Nazarena; Todiere, Giancarlo; Gimelli, Alessia; Chiappino, Dante; Marraccini, Paolo; Schroeder, Stephen; Drosch, Tanja; Poddighe, Rosa; Casolo, Giancarlo; Anagnostopoulos, Constantinos; Pugliese, Francesca; Rouzet, François; Le Guludec, Dominique; Cappelli, Francesco; Valente, Serafina; Gensini, Gian Franco; Zawaideh, Camilla; Capitanio, Selen...     »
Abstract:
Hybrid imaging provides a non-invasive assessment of coronary anatomy and myocardial perfusion. We sought to evaluate the added clinical value of hybrid imaging in a multi-centre multi-vendor setting.Fourteen centres enrolled 252 patients with stable angina and intermediate (20-90%) pre-test likelihood of coronary artery disease (CAD) who underwent myocardial perfusion scintigraphy (MPS), CT coronary angiography (CTCA), and quantitative coronary angiography (QCA) with fractional flow reserve (FFR). Hybrid MPS/CTCA images were obtained by 3D image fusion. Blinded core-lab analyses were performed for CTCA, MPS, QCA and hybrid datasets. Hemodynamically significant CAD was ruled-in non-invasively in the presence of a matched finding (myocardial perfusion defect co-localized with stenosed coronary artery) and ruled-out with normal findings (both CTCA and MPS normal). Overall prevalence of significant CAD on QCA (>70% stenosis or 30-70% with FFR<=0.80) was 37%. Of 1004 pathological myocardial segments on MPS, 246 (25%) were reclassified from their standard coronary distribution to another territory by hybrid imaging. In this respect, in 45/252 (18%) patients, hybrid imaging reassigned an entire perfusion defect to another coronary territory, changing the final diagnosis in 42% of the cases. Hybrid imaging allowed non-invasive CAD rule-out in 41%, and rule-in in 24% of patients, with a negative and positive predictive value of 88% and 87%, respectively.In patients at intermediate risk of CAD, hybrid imaging allows non-invasive co-localization of myocardial perfusion defects and subtending coronary arteries, impacting clinical decision-making in almost one every five subjects.
Journal title abbreviation:
Eur Heart J Cardiovasc Imaging
Year:
2016
Journal volume:
17
Journal issue:
9
Pages contribution:
951-60
Language:
eng
Fulltext / DOI:
doi:10.1093/ehjci/jew038
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/26992419
Print-ISSN:
2047-2404
TUM Institution:
Klinik und Poliklinik für Nuklearmedizin
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