Quantitative imaging of dynamic myocardial blood flow using dual‐head rapidly rotating gantry single‐photon emission computed tomography to enhance coronary artery disease diagnosis

Background This study aimed to evaluate the performance of myocardial blood flow (MBF) and myocardial flow reserve (MFR) for diagnosing coronary artery disease (CAD) using dynamic single‐photon emission computed tomography/computed tomography (SPECT/CT) with a dual‐head rapidly rotating gantry (RRG) and to compare this method with conventional myocardial perfusion imaging (MPI), which can be obtained in a one‐stop manner. Methods A total of 93 patients with suspected or confirmed CAD who underwent RRG SPECT/CT were retrospectively enrolled. They underwent invasive coronary angiography (ICA) and conventional MPI within 3 weeks. Based on the ICA results, the performance of MBF quantitative and semi‐quantitative parameters were compared at patient and vessel levels using ≥50% and ≥75% stenosis as the criteria for CAD diagnosis. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of two types of parameters. Results For patient‐level analysis, the area under ROC curves (AUCs) for stress MBF (sMBF), MFR, summed stress score (SSS), and summed different score (SDS) were 0.971, 0.939, 0.612, and 0.546, respectively, for ≥50% stenosis as positive, and were 0.983, 0.932, 0.735, and 0.509, respectively, for ≥75% stenosis as positive criteria. For vessel‐level analysis, the AUCs of sMBF, MFR, SSS, and SDS were 0.981, 0.933, 0.636, and 0.560, respectively, for ≥50% stenosis as positive and were 0.984, 0.933, 0.767, and 0.583, respectively, for ≥75% stenosis as positive criteria. Conclusions Compared with semi‐quantitative parameters of conventional MPI, MBF quantitative parameters of dual‐head RRG SPECT had higher diagnostic performance for CAD. Dual‐head rapidly rotating gantry single‐photon emission computed tomography can measure quantitative myocardial blood flow parameters without increasing the radiation exposure of patients. Compared with traditional semi‐quantitative parameters, quantitative myocardial blood flow parameters have higher diagnostic efficiency for coronary artery disease detection and good diagnostic value for patients with single‐vessel and multivessel disease.