Key result
Adenosine 2D- and 3D-MCE demonstrated high sensitivity (90-92%) and moderate specificity (69-79%) for assessing myocardial perfusion when compared with SPECT as the reference standard.
Why the study?
Does adenosine 2D- and 3D-MCE provide comparable diagnostic accuracy to SPECT for assessing myocardial perfusion in patients with known or suspected CAD?
Observational (n=30)
Does adenosine 2D- and 3D-MCE provide comparable diagnostic accuracy to SPECT for assessing myocardial perfusion in patients with known or suspected CAD?
Adenosine 3D-MCE is a feasible alternative to SPECT for assessing myocardial perfusion, offering comparable diagnostic accuracy with the advantage of rapid acquisition.
Supports MCE as a potential radiation-sparing perfusion test; leaves open prospective outcome trials before clinical adoption.
OBJECTIVES: To evaluate diagnostic accuracy of adenosine two-dimensional and three-dimensional myocardial contrast echocardiography (2D- and 3D-MCE) compared with single-photon emission computed tomography (SPECT) for assessing myocardial perfusion. METHODS: From January through August 2007, patients with known or suspected CAD who were referred for SPECT underwent simultaneous adenosine 2D-MCE and 3D-MCE (live and full volume [FV]). Perfusion and wall motion in 17 segments in the left anterior descending, left circumflex, and right coronary artery territories were analyzed. RESULTS: We studied 30 patients: mean (SD) age, 72.6 (8.2) years; 19 (63%) men. Perfusion by SPECT was abnormal in 13 patients (43%). When comparing MCE with SPECT, sensitivity was comparable for 2D-MCE, 92%; live 3D-MCE, 91%; and FV 3D-MCE, 90%. Specificity was comparable for 2D-MCE, 75%; live 3D-MCE, 69%; and FV 3D-MCE, 79%. Agreement between live 3D-MCE and 2D-MCE was 92% (kappa[SE], 0.83 [0.17]) and between FV 3D-MCE and 2D-MCE, 88% (kappa[SE], 0.76 [0.13]). For eight patients in whom SPECT showed reversible defects, live 3D-MCE correctly identified defects in seven (88%), whereas FV 3D-MCE correctly identified them in five (63%) (P = 0.57). CONCLUSION: Myocardial perfusion assessment is feasible by 3D-MCE with the advantage of rapid, facile acquisition and offline image manipulation.
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Abdelmoneim et al. (2010) conducted an observational in Known or suspected coronary artery disease (n=30). Adenosine 2D- and 3D-myocardial contrast echocardiography (MCE) vs. Single-photon emission computed tomography (SPECT) was evaluated on Diagnostic accuracy (sensitivity and specificity) for assessing myocardial perfusion. Adenosine 2D- and 3D-MCE demonstrated high sensitivity (90-92%) and moderate specificity (69-79%) for assessing myocardial perfusion when compared with SPECT as the reference standard.
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