Quantitative myocardial perfusion 82Rb-PET assessed by hybrid PET/coronary-CT: Normal values and diagnostic performance.

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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