Positron emission tomography may be the most accurate non-invasive diagnostic for evaluating myocardial perfusion or coronary artery stenosis severity in suspected coronary artery disease patients, according to a new study.
The 208-patient Pacific study explored the accuracy differences between PET, single photon emission computed tomography and coronary computed tomography angiography, and compared all 3 against the “gold standard diagnostic test,” invasive coronary angiography.
“At present, there is little consensus about the choice of non-invasive imaging modality, and European and US guidelines do not advocate for any one over another. The vast majority of studies used invasive coronary angiography as a reference standard, which may lead to erroneous interpretations. These data represent the first comprehensive evaluation of coronary artery disease and will help to guide the clinician to choose the appropriate non-invasive test for his or her patients,” Dr. Ibrahim Danad of Amsterdam’s VU University Medical Center said in a press release.
Data from the indicated that PET was the most accurate, at 85% accuracy compared to invasive coronary angiography, with accuracy rates at 74% for CCTA and 77% for SPECT.
“This study’s findings are novel and, to our knowledge, represent the first of its kind to evaluate diagnostic performance of non-invasive imaging modalities against a widely considered reference standard for functionally significant CAD. The results will definitely spark further research. There is always a lot of discussion whether we need to choose SPECT or PET as the initial functional test for our patients. I think that we need to invest more in clinical PET imaging, which will be future. It is more convenient for patients in terms of time, accuracy and radiation dos,” Danad said in prepared remarks.
Sensitivity of the non-invasive approaches were at 87% for PET, 90% for CCTA and 57% with SPECT, while specificity was at 60% for PET, 94% for CCTA and 84% for SPECT, according to the study.