Why the study?
Does a tagged gradient-echo (SPAMM-GRE) sequence improve diagnostic accuracy compared to spoiled gradient-echo (sGRE) during high-dose dobutamine stress at 3 T in patients evaluated for coronary artery disease?
Does a tagged gradient-echo (SPAMM-GRE) sequence improve diagnostic accuracy compared to spoiled gradient-echo (sGRE) during high-dose dobutamine stress at 3 T in patients evaluated for coronary artery disease?
A combined sGRE and SPAMM-GRE high-dose dobutamine protocol at 3 T is feasible and provides good diagnostic accuracy for coronary artery disease, with tagging potentially increasing sensitivity and detecting wall motion abnormalities at lower stress levels.
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SPAMM-GRE may modestly improve sensitivity in dobutamine stress CMR; hypothesis-generating and should not yet change practice.
OBJECTIVE: The purpose of this study was to evaluate the feasibility and diagnostic accuracy of a combined spoiled gradient-echo (sGRE) and tagged gradient-echo (SPAMM-GRE) protocol for detection of coronary artery disease (CAD) during high-dose dobutamine stress at 3 T. METHOD: The study protocol was approved by the local ethics committee. For stress testing, a standard high-dose dobutamine protocol was employed. Image quality at the highest stress level and diagnostic accuracy of the sGRE and SPAMM-GRE sequences were compared. The final study population consisted of 37 patients. RESULTS: The mean image quality score was 2.6±0.6 for the sGRE sequence and 2.4±0.6 for the SPAMM-GRE sequence (p>0.05). Sensitivity, specificity and diagnostic accuracy were 0.81, 0.86, 0.84 and 0.88, 0.86, 0.86 for the sGRE and SPAMM-GRE, respectively. In three cases with new wall motion abnormalities (WMAs), detected by sGRE and SPAMM-GRE, WMAs were detected at a lower stress level by tagging. CONCLUSION: The combined sGRE and SPAMM-GRE high-dose dobutamine protocol at 3 T is feasible and delivers good diagnostic accuracy. Tagging increases the sensitivity of high-dose dobutamine stress testing for detection of CAD and may allow for detection of new WMAs at lower stress levels compared with sGRE alone.
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Thomas et al. (2010) studied this question.
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