Reevaluation of Computed Tomography-Based Attenuation Correction on Myocardial Perfusion Imaging Compared With Coronary Angiography Findings

Background: Noninvasive diagnostic methods for coronary artery disease (CAD) are a health priority. Coronary angiography (CA) is currently the gold-standard method for diagnosing CAD. Myocardial perfusion imaging (MPI) is used to diagnose CAD as well. This study aimed to reevaluate the effects of computed tomography (CT)-based attenuation correction on MPI results compared with CA findings. Methods: This cross-sectional study enrolled 293 patients referred to Rajaie Cardiovascular Medical and Research Center. The study population underwent MPI with CT-based attenuation correction and CA to diagnose CAD within 3 months. Results: In the right coronary artery (RCA) territory, CT-based attenuation correction led to a significant decrease in MPI sensitivity in men and an increase in specificity in all the patients except those with a normal body mass index. In the left circumflex coronary artery (LCX) territory, a significant reduction in sensitivity was noted just in overweight patients, while specificity improved merely in men. In the left anterior descending artery (LAD) territory, none of the diagnostic parameters changed significantly with attenuation correction. Conclusions: Performing CT-based attenuation correction significantly enhanced diagnostic specificity and worsened sensitivity in the RCA and LCX territories. The advantage of CT-based attenuation correction is more pronounced in patients with a normal body mass index and women.