CLINICAL RESEARCH: CARDIAC IMAGING
Diagnostic Accuracy of Rubidium-82 Myocardial Perfusion Imaging With Hybrid Positron Emission Tomography/Computed Tomography in the Detection of Coronary Artery Disease
Uchechukwu K. Sampson, MD, MPH, MBA, MSc(Oxon)*,
Sharmila Dorbala, MD, FACC*, ,
Atul Limaye, MD, MRCP*,
Raymond Kwong, MD*, and
Marcelo F. Di Carli, MD, FACC, FAHA*,,*
* Divisions of Nuclear Medicine and Cardiovascular Imaging, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
Division of Cardiology, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts.
Manuscript received April 26, 2006;
revised manuscript received August 21, 2006,
accepted August 28, 2006.
* Reprint requests and correspondence: Dr. Marcelo F. Di Carli, Division of Nuclear Medicine/PET, Department of Radiology, Brigham and Women’s Hospital, 75 Francis Street, Boston, Massachusetts 02115. (Email: mdicarli{at}partners.org).
Objectives: Our objective was to determine the accuracy of rubidium-82 myocardial perfusion positron emission tomography-computed tomography (PET-CT) imaging for detecting obstructive coronary artery disease (CAD).
Background: Hybrid PET-CT is a new noninvasive imaging modality for evaluating patients with known or suspected CAD.
Methods: We evaluated 64 consecutive patients with suspected CAD undergoing rest-stress rubidium-82 cardiac PET-CT (CT was only used for attenuation correction) and coronary angiography within 7 days (range 1 to 180 days). Patients with known CAD, previous myocardial infarction, or revascularization were excluded. Thirty-eight patients with a low likelihood for CAD were also studied. Obstructive CAD was defined as  70% diameter stenosis on angiography.
Results: The mean age of the patients was 62 ± 15 years, with a body mass index of 31 ± 8 kg/m2. Chest pain and/or dyspnea were the predominant reasons for evaluation. Stress perfusion defects were detected in 41 of 44 patients with obstructive CAD (sensitivity 93%, 95% confidence interval [CI] 87 to 99). The specificity of PET-CT was 83% (48 of 58, 95% CI 71 to 91), and its overall diagnostic accuracy was 87% (95% CI 79 to 93). All patients with a low likelihood for CAD showed normal scans, for a normalcy rate of 100% (38 of 38, 95% CI 91 to 100). The sensitivity for detecting CAD in patients with single and multivessel (2 vessels) disease was 92% (22 of 24, 95% CI 74 to 99) and 95% (19 of 20, 95% CI 74 to 99), respectively.
Conclusions: Myocardial perfusion PET-CT affords high sensitivity and overall accuracy for detecting CAD, including patients with single-vessel disease, women, and obese patients.
|
Abbreviations and Acronyms
| | BMI = body mass index | | CAD = coronary artery disease | | CI = confidence interval | | CT = computed tomography | | MI = myocardial infarction | | PET = positron emission tomography | | SPECT = single-photon emission computed tomography |
|
This article has been cited by other articles:
|
|
|
|
 
P. J. Slomka, L. Le Meunier, S. W. Hayes, W. Acampa, M. Oba, G. G. Haemer, D. S. Berman, and G. Germano
Comparison of Myocardial Perfusion 82Rb PET Performed with CT- and Transmission CT-Based Attenuation Correction
J. Nucl. Med.,
December 1, 2008;
49(12):
1992 - 1998.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Chander, M. Brenner, R. Lautamaki, C. Voicu, J. Merrill, and F. M. Bengel
Comparison of Measures of Left Ventricular Function from Electrocardiographically Gated 82Rb PET with Contrast-Enhanced CT Ventriculography: A Hybrid PET/CT Analysis
J. Nucl. Med.,
October 1, 2008;
49(10):
1643 - 1650.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. L. Gould, T. Pan, C. Loghin, N. P. Johnson, and S. Sdringola
Reducing Radiation Dose in Rest-Stress Cardiac PET/CT by Single Poststress Cine CT for Attenuation Correction: Quantitative Validation
J. Nucl. Med.,
May 1, 2008;
49(5):
738 - 745.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J Knuuti and F M Bengel
Positron emission tomography and molecular imaging
Heart,
March 1, 2008;
94(3):
360 - 367.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Schroeder, S. Achenbach, F. Bengel, C. Burgstahler, F. Cademartiri, P. de Feyter, R. George, P. Kaufmann, A. F. Kopp, J. Knuuti, et al.
Cardiac computed tomography: indications, applications, limitations, and training requirements: Report of a Writing Group deployed by the Working Group Nuclear Cardiology and Cardiac CT of the European Society of Cardiology and the European Council of Nuclear Cardiology
Eur. Heart J.,
February 2, 2008;
29(4):
531 - 556.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. N. DeMaria, J. J. Bax, O. Ben-Yehuda, P. Clopton, G. K. Feld, G. S. Ginsburg, B. H. Greenberg, J. D. Knoke, W. Y.W. Lew, J. A.C. Lima, et al.
Highlights of the year in JACC 2007.
J. Am. Coll. Cardiol.,
January 29, 2008;
51(4):
490 - 512.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. M. Bateman
Business Aspects of Cardiovascular Computed Tomography: Tackling the Challenges
J. Am. Coll. Cardiol. Img.,
January 1, 2008;
1(1):
111 - 118.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. L. Gould
Not All Randomized Trials Are Equal
J. Am. Coll. Cardiol.,
November 13, 2007;
50(20):
2013 - 2015.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. J. Gibbons, P. A. Araoz, and E. E. Williamson
The Year in Cardiac Imaging
J. Am. Coll. Cardiol.,
September 4, 2007;
50(10):
988 - 1003.
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. L. Gould, T. Pan, C. Loghin, N. P. Johnson, A. Guha, and S. Sdringola
Frequent Diagnostic Errors in Cardiac PET/CT Due to Misregistration of CT Attenuation and Emission PET Images: A Definitive Analysis of Causes, Consequences, and Corrections
J. Nucl. Med.,
July 1, 2007;
48(7):
1112 - 1121.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. A. Santana, R. D. Folks, E. V. Garcia, L. Verdes, R. Sanyal, J. Hainer, M. F. Di Carli, and F. P. Esteves
Quantitative 82Rb PET/CT: Development and Validation of Myocardial Perfusion Database
J. Nucl. Med.,
July 1, 2007;
48(7):
1122 - 1128.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. F. Di Carli, S. Dorbala, J. Meserve, G. El Fakhri, A. Sitek, and S. C. Moore
Clinical Myocardial Perfusion PET/CT
J. Nucl. Med.,
May 1, 2007;
48(5):
783 - 793.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
