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A randomized , multicenter , multivendor study of myocardial perfusion imaging with regadenoson CT perfusion vs single photon emission CT. BACKGROUND Myocardial CT perfusion ( CTP ) is a promising tool for the detection of myocardial ischemia . We hypothesize that regadenoson CTP is noninferior to regadenoson single photon emission CT ( SPECT ) for detecting or excluding myocardial ischemia . METHODS Patients ( men ≥ 45 years ; women ≥ 50 years ) with known or suspected coronary artery disease ( n = 124 ) were randomized to 1 of 2 diagnostic sequences : rest and regadenoson SPECT on day 1 , then regadenoson CTP and rest CTP ( and coronary CT angiography [ CTA ] ) ( CTA ; same acquisition ) on day 2 or regadenoson CTP and rest CTP ( and CTA ) on Day 1 , then rest and regadenoson SPECT on day 2 . Scanning platforms included 64- , 128- , 256- , and 320-slice systems . The primary analysis examined the agreement rate between CTP and SPECT for detecting or excluding reversible ischemia in ≥ 2 myocardial segments as assessed by independent , blinded readers . RESULTS Complete and interpretable CTP and SPECT scans were obtained for 110 patients . Regadenoson CTP was noninferior to SPECT for detecting or excluding reversible ischemia with an agreement rate of 0.87 ( 95 % confidence interval [ CI ] , 0.77-0.97 ) and sensitivity and specificity of 0.90 ( 95 % CI , 0.71-1.00 ) and 0.84 ( 95 % CI , 0.77-0.91 ) , respectively . The agreement rate for detecting or excluding ≥ 1 fixed defects by regadenoson CTP and SPECT was 0.86 ( 95 % CI , 0.74-0.98 ) . With SPECT as the reference standard , the diagnostic accuracies for detecting or excluding ischemia by regadenoson CTP and CTA alone were 0.85 ( 95 % CI , 0.78-0.91 ) and 0.69 ( 95 % CI , 0.60-0.77 ) , respectively . CONCLUSIONS This study establishes the noninferiority of regadenoson CTP to SPECT for detecting or excluding myocardial ischemia .
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Intervention_Surgical
regadenoson CT perfusion
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Intervention_Surgical
single photon emission CT.
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Outcome_Physical
the agreement rate between CTP and SPECT for detecting or excluding reversible ischemia
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Outcome_Physical
SPECT for detecting or excluding reversible ischemia
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Outcome_Other
respectively
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Outcome_Other
The agreement
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Outcome_Other
excluding ≥ 1 fixed
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Participant_Condition
myocardial ischemia
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Participant_Condition
myocardial ischemia
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Participant_Sex
men
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Participant_Age
45 years
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Participant_Sex
women
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Participant_Age
50 years
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Participant_Condition
coronary artery disease
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Participant_Sample-size
124
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Participant_Sample-size
110
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Participant_Condition
myocardial ischemia