Freitag, Martin T; Bremerich, Jens; Wild, Damian; Haaf, Philip; Zellweger, Michael J; Caobelli, Federico (2022). Quantitative myocardial perfusion 82Rb-PET assessed by hybrid PET/coronary-CT: Normal values and diagnostic performance. Journal of nuclear cardiology, 29(2), pp. 464-473. Springer 10.1007/s12350-020-02264-4
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PURPOSE
We aimed to assess normal values for quantified myocardial blood flow (MBF) on a hybrid PET/coronary-CT scanner and to test their diagnostic performance in patients with suspected CAD.
MATERIALS AND METHODS
Patients underwent 82Rb-PET/CT and integrated CT-based coronary angiography (CCTA) and were classified as normal (no stenosis), with non-obstructive stenosis (< 50%) and with CAD (≥ 50%). Global and regional stress MBF (sMBF), rest MBF and myocardial flow reserve (MFR) were calculated. Ischemia was defined as SDS ≥ 2, severe ischemia as SDS ≥ 7.
RESULTS
357 consecutive patients were included. Global sMBF and MFR were higher in normal patients than in patients with CAD (3.61 ± 0.71 vs 3.04 ± 0.77, P < 0.0001; 3.08 ± 0.84 vs 2.68 ± 0.79, P = 0.0001), but not different compared to patients with non-obstructive stenosis (3.61 ± 0.71 vs 3.43 ± 0.69, P = 0.052; 3.08 ± 0.84 vs 2.99 ± 0.82, P = 0.45). sMBF yielded superior accuracy over MFR in identifying both ischemia (AUC 0.74 vs 0.62, P = 0.003) and severe ischemia (AUC 0.88 vs 0.78, P = 0.012). Optimal threshold for global sMBF to rule out myocardial ischemia was 3.5 mL g-1 min-1.
CONCLUSIONS
Normal quantitative values are provided. Global sMBF provided higher diagnostic accuracy than MFR. Using sMBF-threshold of 3.5 mL·g-1·min-1 on 82Rb-PET/CT yielded similar NPV (96%) as CCTA to rule out CAD. Hence, resting scan could be omitted in patients with sMBF values above reference.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Clinic of Nuclear Medicine |
UniBE Contributor: |
Caobelli, Federico |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1071-3581 |
Publisher: |
Springer |
Language: |
English |
Submitter: |
Daria Vogelsang |
Date Deposited: |
15 Dec 2022 10:17 |
Last Modified: |
15 Dec 2022 18:38 |
Publisher DOI: |
10.1007/s12350-020-02264-4 |
PubMed ID: |
32676910 |
Uncontrolled Keywords: |
Myocardial perfusion imaging coronary-CT quantitative perfusion positron emission tomography rubidium 82 |
BORIS DOI: |
10.48350/175888 |
URI: |
https://boris.unibe.ch/id/eprint/175888 |
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