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.