A COMPARISON OF TC-99M-MIBI MYOCARDIAL SPET WITH ELECTRON-BEAM COMPUTED-TOMOGRAPHY IN THE ASSESSMENT OF CORONARY-ARTERY DISEASE

We compared technetium-99m methoxyisobutylisonitrile (MIBI) myocardial perfusion single-photon emission tomography (SPET) (MIPS) and electro n beam computed tomography (EBCT) in order to assess their respective value in the detection of coronary artery disease (CAD). Tc-99m-MIBI S PET (stress-resting) and EBCT studies were performed in 51 patients wi th suspected CAD who underwent coronary angiography (GAG). CAG showed that of the 51 patients, 36 had coronary stenosis greater than or equa l to 50% while 15 had normal results. A moderate positive rank correla tion was found between coronary calcification detected by EBCT and MPS score (r(s)=0.5283, P<0.01). The concordance between EBCT and MPS for the evaluation of CAD was 72.5% (37/51). The sensitivity of EBCT in d etecting CAD in 51 patients was comparable to that of MPS (81% vs 94%, NS). However, the accuracy of EBCT was lower than that of MPS (78% vs 94%, P<0.025). As regards the detection of individual coronary artery disease, there was no significant difference in sensitivity between E BCT and MPS (65% vs 75%, NS); however, the specificity and accuracy of EBCT were lower than those of MPS (specificity: 77% vs 95%, P<0.005; accuracy 71% vs 85%, P<0.005). The sensitivity, specificity and accura cy of MPS in detecting single-vessel disease were higher than those of EBCT (sensitivity: 86% vs 42%, P<0.025; specificity: 96% vs 70%, P<0. 025; accuracy: 93% vs 61%, P<0.005). However, no significant differenc es in the sensitivity, specificity and accuracy of MPS and EBCT were f ound in respect of multivessel disease. In conclusion: Tc-99m-MIBI myo cardial perfusion SPET and EBCT provide different information in the a ssessment of CAD. The sensitivity of EBCT for the detection of CAD is comparable with that of MPS; however, the specificity and accuracy of EBCT are lower than those of MPS.