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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
- Source :
- Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid, Consejería de Sanidad de la Comunidad de Madrid, European Heart Journal-Cardiovascular Imaging, 17(9), 951-960
- Publication Year :
- 2016
-
Abstract
- Aims 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. Methods and results 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 colocalized 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. Conclusion 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. -------------------------------------------------------------------------------------------------------------------------------
- Subjects :
- Male
Radiology, Nuclear Medicine and Imaging
Internationality
Computed Tomography Angiography
CT coronary angiography
Myocardial Ischemia
Fractional flow reserve
Coronary Artery Disease
030204 cardiovascular system & hematology
Coronary Angiography
Myocardial perfusion scintigraphy
Multimodal Imaging
Coronary artery disease
EVINCI Study Investigators
030218 nuclear medicine & medical imaging
Cohort Studies
Computer-Assisted
0302 clinical medicine
Retrospective Studie
Tomography
Cardiac imaging
health care economics and organizations
Computed tomography angiography
Observer Variation
education.field_of_study
medicine.diagnostic_test
Statistics
Myocardial Perfusion Imaging
General Medicine
Middle Aged
Fractional Flow Reserve
3. Good health
Europe
Fractional Flow Reserve, Myocardial
medicine.anatomical_structure
Cardiology
Female
Radiology
Cardiology and Cardiovascular Medicine
Human
medicine.medical_specialty
Population
Sensitivity and Specificity
Hybrid imaging
Aged
Humans
Positron-Emission Tomography
Retrospective Studies
Statistics, Nonparametric
Tomography, Emission-Computed, Single-Photon
Image Interpretation, Computer-Assisted
03 medical and health sciences
Myocardial perfusion imaging
Internal medicine
medicine
Medical imaging
Myocardial
Nonparametric
education
Image Interpretation
business.industry
Original Articles
ta3121
medicine.disease
Coronary arteries
Emission-Computed
Cohort Studie
business
Single-Photon
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid, Consejería de Sanidad de la Comunidad de Madrid, European Heart Journal-Cardiovascular Imaging, 17(9), 951-960
- Accession number :
- edsair.doi.dedup.....1ee817087a843e89a04e4d588f071d6f