Coronary artery calcification detected by PET/CT scan as a marker of myocardial ischemia/coronary artery disease.

BACKGROUND

There have been no data with regard to the relationship between coronary artery calcification (CAC) detected with positron emission tomography (PET)/computed tomography (CT), as incidental findings, and myocardial perfusion single photon computed tomography (MPS) results in patients with cancer.

OBJECTIVES

The main objective of this study was to investigate the relationship between CAC detected on the CT component of PET/CT and abnormal MPS in patients with cancer before oncologic surgery.

METHOD

A total of 157 patients without known coronary disease and clinically proven indication for PET/CT underwent PET/CT and MPS as a routine preoperative workup. PET/CT and MPS were performed within 3 months. The frequency of abnormal MPS was compared with the presence or absence of CAC. CAC was evaluated visually.

RESULTS

Among 81 patients with no CAC, MPS results were normal in 71 patients (88%). Only 10 patients (20%) with no CAC had abnormal MPS (P<0.005) results. However, in the total patient population with visually detectable CAC (76 patients), MPS results were normal in 36 patients (47%) and abnormal in 40 patients (53%) with no statistically significant value. CAC and diabetes mellitus were the most potent predictors of abnormal MPS by multivariable analysis.

CONCLUSIONS

Visual detection of CAC in the CT component of PET/CT is a strong predictor of MPS results. The presence of CAC is associated with a high likelihood of abnormal MPS, but the absence of CAC is rarely associated with abnormal MPS. These findings imply a potential role for applying routine visual CAC detection in the CT component of PET/CT and might obviate unnecessary MPS indications in the preoperative evaluation in patients with cancer.