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DIAGNOSTIC ACCURACY OF QUANTITATIVE RUBIDIUM-82 POSITRON EMISSION TOMOGRAPHY MYOCARDIAL PERFUSION IMAGING: VALIDATION WITH INVASIVE CORONARY ANGIOGRAPHY
E652 JACC April 5, 2011 Volume 57, Issue 14
IMAGING AND DIAGNOSTIC TESTING DIAGNOSTIC ACCURACY OF QUANTITATIVE RUBIDIUM-82 POSITRON EMISSION TOMOGRAPHY MYOCARDIAL PERFUSION IMAGING: VALIDATION WITH INVASIVE CORONARY ANGIOGRAPHY ACC Oral Contributions Ernest N. Morial Convention Center, Room 254 Tuesday, April 05, 2011, 2:30 p.m.-2:45 p.m.
Session Title: Nuclear Cardiology/PET: Applications, Accuracy and Prognosis Abstract Category: 39. Nuclear Cardiology/PET Presentation Number: 926-5 Authors: Ryo Nakazato, Piotr J. Slomka, Sean W. Hayes, Victor Y. Cheng, Jimmy S. Fermin, Louise E.J. Thomson, John D. Friedman, Guido Germano, Daniel S. Berman, Cedars-Sinai Medical Center, Los Angeles, CA Background: Automated quantitative myocardial perfusion imaging with positron emission tomography/computed tomography (PET/CT) has been described; however, there have been few reports of their accuracy for detecting coronary artery disease (CAD). The purpose of this study was to determine the diagnostic accuracy of automated quantification of rubidium-82 (82Rb) myocardial perfusion PET/CT for detection of obstructive CAD in comparison to invasive coronary angiography (ICA). Methods: We evaluated 83 consecutive patients (53 males) without known CAD undergoing 82Rb-PET/CT, who had diagnostic ICA within 6 months of PET/CT. CT was used for attenuation correction. Normal limits for PET/CT perfusion, created from studies of patients with a low likelihood of CAD, were used with thresholds based on previous data from our center. Automated software was used to quantify the perfusion abnormality, which was expressed as total perfusion deficit (TPD). Stress TPD ≥ 5% myocardium was considered abnormal for per-patient analysis. Results: The mean age was 70 ± 12 years, with a body mass index of 28 ± 6 kg/m2. In this population, 61 patients had ≥ 50% stenosis and 52 patients had ≥ 70% stenosis by ICA. The areas under the receiver operating characteristic curves were 0.88 and 0.87 for identification of ≥ 50% and ≥ 70% stenosis, respectively. On a per-patient basis, the sensitivity and specificity was 86% and 86% for detecting ≥ 50% stenosis, 93% and 77% for detecting ≥ 70% stenosis, respectively. Conclusions: Automated quantification of 82Rb-PET/CT shows high diagnostic accuracy for detecting obstructive CAD.
IMAGING AND DIAGNOSTIC TESTING DIAGNOSTIC ACCURACY OF QUANTITATIVE RUBIDIUM-82 POSITRON EMISSION TOMOGRAPHY MYOCARDIAL PERFUSION IMAGING: VALIDATION WITH INVASIVE CORONARY ANGIOGRAPHY ACC Oral Contributions Ernest N. Morial Convention Center, Room 254 Tuesday, April 05, 2011, 2:30 p.m.-2:45 p.m.
Session Title: Nuclear Cardiology/PET: Applications, Accuracy and Prognosis Abstract Category: 39. Nuclear Cardiology/PET Presentation Number: 926-5 Authors: Ryo Nakazato, Piotr J. Slomka, Sean W. Hayes, Victor Y. Cheng, Jimmy S. Fermin, Louise E.J. Thomson, John D. Friedman, Guido Germano, Daniel S. Berman, Cedars-Sinai Medical Center, Los Angeles, CA Background: Automated quantitative myocardial perfusion imaging with positron emission tomography/computed tomography (PET/CT) has been described; however, there have been few reports of their accuracy for detecting coronary artery disease (CAD). The purpose of this study was to determine the diagnostic accuracy of automated quantification of rubidium-82 (82Rb) myocardial perfusion PET/CT for detection of obstructive CAD in comparison to invasive coronary angiography (ICA). Methods: We evaluated 83 consecutive patients (53 males) without known CAD undergoing 82Rb-PET/CT, who had diagnostic ICA within 6 months of PET/CT. CT was used for attenuation correction. Normal limits for PET/CT perfusion, created from studies of patients with a low likelihood of CAD, were used with thresholds based on previous data from our center. Automated software was used to quantify the perfusion abnormality, which was expressed as total perfusion deficit (TPD). Stress TPD ≥ 5% myocardium was considered abnormal for per-patient analysis. Results: The mean age was 70 ± 12 years, with a body mass index of 28 ± 6 kg/m2. In this population, 61 patients had ≥ 50% stenosis and 52 patients had ≥ 70% stenosis by ICA. The areas under the receiver operating characteristic curves were 0.88 and 0.87 for identification of ≥ 50% and ≥ 70% stenosis, respectively. On a per-patient basis, the sensitivity and specificity was 86% and 86% for detecting ≥ 50% stenosis, 93% and 77% for detecting ≥ 70% stenosis, respectively. Conclusions: Automated quantification of 82Rb-PET/CT shows high diagnostic accuracy for detecting obstructive CAD.