Multimodality Cardiac Stress Testing: Combining Real-Time 3-Dimensional Echocardiography and Myocardial Perfusion SPECT

Early experience is described in implementing a new multimodality stress test for accurate correlation of complementary functional and perfusion information from real-time 3-dimensional (3D) echocardiography and SPECT, respectively. The proposed new multimodality stress test has the potential for simultaneously improving sensitivity and specificity in the detection of early coronary artery disease (CAD). Methods: Pre- and post-stress real-time 3D echocardiography and SPECT images were acquired in 20 patients referred for CAD evaluation and processed using previously developed algorithms for automatic fusion and quantitative analysis of myocardial function and perfusion. All cases of CAD were diagnosed by reviewing quantitatively analyzed fused images, using newly developed software. Results: Real-time 3D echocardiography, SPECT, advance processing, and image review were successfully performed in all 20 patients. Compared with the angiographic findings in 12 patients, diagnosis based on fused images correctly identified 13 of 13 diseased arteries, compared with 11 of 13 identified by SPECT and 6 of 13 identified by echocardiography-based analysis. Conclusion: The results suggest the feasibility and potential effectiveness of novel multimodality stress testing.