Purpose. Our purpose was to combine the results of the MDCT (multidetector computed tomography) morphological data and the SPECT (single-photon emission computed tomography) data using hybrid imaging to overcome the limits of the MDCT in the evaluation of coronary stenosis in diabetic patients with large amount of calcium in the coronary arteries. Method and Materials. 120 diabetic patients underwent MDCT examination and SPECT examination. We evaluated 324 coronary arteries. After the examinations, we merged CT and SPECT images. Results. CT evaluation: 52 (32.8%) coronaries with stenosis ≥ 50%, 228 (70.4%) with stenosis < 50%, and 44 (13.6%) with a doubtful evaluation. SPECT evaluation: 80 (24.7%) areas with hypoperfusion, 232 (71.6%) with normal perfusion, and 12 (3.7%) with a doubtful evaluation. Of 324 coronary arteries and corresponding areas, the hybrid SPECT/CT evaluation showed 92 (28.4%) areas with hypoperfusion, and 232 (71.6%) with normal perfusion. Conclusion. Hybrid CT/SPECT imaging could be useful in the detection of significant coronary stenosis in patients with large amount of coronary calcifications. 1. Introduction Diabetes mellitus type 2 is strictly related to CAD (coronary artery disease); in fact 70–80% of diabetic patients die of cardiovascular complications; moreover, these patients have a risk of myocardial infarction about four times higher than that found in the general population [1–3]. Therefore, the early detection of CAD in diabetic patients is very important. Several noninvasive techniques are available for this purpose, including stress ECG and SPECT (single photon emission computed tomography) [4, 5] and most recently coronary CT. In fact the latest CT generation with 64 slices has emerged as a truthful alternative to conventional CA (coronary angiography), with excellent diagnostic accuracy allowing us to identify and quantify the degree and extent of coronary artery disease, including the study of wall arteries [6–9]. Previously published results have proved the high values of sensitivity, specificity, and negative predictive value (almost 100%) of CT for the assessment of coronary disease, even in patients treated with stent and bypass [10, 11]. However, in case of important coronary calcifications, the CT examination presents several limitations in residual vessel lumen evaluation [12]. Otherwise, MDCT (multidetector computed tomography) sometimes shows some limitations in the grading of coronary stenosis due to motion artefacts or severe vessel calcifications. It is well known that diabetes causes a large amount of
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