Diagnostic accuracy of rest/stress ECG-gated Rb-82 myocardial perfusion PET: Comparison with ECG-gated Tc-99m sestamibi SPECT

被引:341
作者
Bateman, TM
Heller, GV
McGhie, AI
Friedman, JD
Case, JA
Bryngelson, JR
Hertenstein, GK
Moutray, KL
Reid, K
Cullom, SJ
机构
[1] Cardiovasc Consultants, PC, Kansas City, MO 64111 USA
[2] Cardiovasc Imaging Technol LLC, Kansas City, MO USA
[3] Mid Amer Heart Inst, Kansas City, MO USA
[4] Hartford Hosp, Henry Low Heart Ctr, Div Cardiol, Hartford, CT 06115 USA
[5] Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA
关键词
single photon emission computed tomography; positron emission tomography; myocardial perfusion imaging;
D O I
10.1016/j.nuclcard.2005.12.004
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Although single photon emission computed tomography (SPECT) and positron emission tomography (PET) myocardial perfusion imaging (MPI) have evolved considerably over the last decade, there is no recent comparison of diagnostic performance. This study was designed to assess relative image quality, interpretive confidence, and diagnostic accuracy by use of contemporary technology and protocols. Methods and Results. By consensus and without clinical information, 4 experienced nuclear cardiologists interpreted 112 SPECT technetium-99m sestamibi and 112 PET rubidium-82 MPI electrocardiography (ECG)-gated rest/pharmacologic stress studies in patient populations matched by gender, body mass index, and presence and extent of coronary disease. The patients were categorized as having a low likelihood for coronary artery disease (27 in each group) or had coronary angiography within 60 days. SPECT scans were acquired on a Cardio-60 system and PET scans on an ECAT ACCEL scanner. Image quality was excellent for 78% and 79% of rest and stress PET scans, respectively, versus 62% and 62% of respective SPECT scans (both p <.05). An equal percent of PET and SPECT gated images were rated excellent in quality. Interpretations were definitely normal or abnormal for 96% of PET scans versus 81% of SPECT scans (p =.001). Diagnostic accuracy was higher for PET for both stenosis severity thresholds of 70% (89% vs 79%,p =.03) and 50% (87% vs 71%,p =.003) and was higher in men and women, in obese and nonobese patients, and for correct identification of multivessel coronary artery disease. Conclusion. In a large population of matched pharmacologic stress patients, myocardial perfusion PET was superior to SPECT in image quality, interpretive certainty, and diagnostic accuracy.
引用
收藏
页码:24 / 33
页数:10
相关论文
共 40 条
[1]   Attenuation correction single-photon emission computed tomography myocardial perfusion imaging [J].
Bateman, TM ;
Cullom, SJ .
SEMINARS IN NUCLEAR MEDICINE, 2005, 35 (01) :37-51
[2]  
Bateman TM, 2004, AM J CARDIOL, V94, p19D
[3]  
Case JA, 2003, J NUCL CARDIOL, V10, P105, DOI 10.1067/mnc.2003.14
[4]   Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart - A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association [J].
Cerqueira, MD ;
Weissman, NJ ;
Dilsizian, V ;
Jacobs, AK ;
Kaul, S ;
Laskey, WK ;
Pennell, DJ ;
Rumberger, JA ;
Ryan, T ;
Verani, MS .
CIRCULATION, 2002, 105 (04) :539-542
[5]  
Cullom SJ, 2002, J NUCL MED, V43, p197P
[6]  
DEPUEY E, 1995, J NUCL MED, V36, P952
[7]   Updated imaging guidelines for nuclear cardiology procedures, part 1 [J].
DePuey, EG ;
Garcia, EV .
JOURNAL OF NUCLEAR CARDIOLOGY, 2001, 8 (01) :G3-G58
[8]   Impact of an abbreviated adenosine protocol incorporating adjunctive treadmill exercise on adverse effects and image duality in patients undergoing stress myocardial perfusion imaging [J].
Elliott, MD ;
Holly, TA ;
Leonard, SM ;
Hendel, RC .
JOURNAL OF NUCLEAR CARDIOLOGY, 2000, 7 (06) :584-589
[9]   COMPARISON BETWEEN TL-201 AND TC-99M SESTAMIBI UPTAKE DURING ADENOSINE-INDUCED VASODILATION AS A FUNCTION OF CORONARY STENOSIS SEVERITY [J].
GLOVER, DK ;
RUIZ, M ;
EDWARDS, NC ;
CUNNINGHAM, M ;
SIMANIS, JP ;
SMITH, WH ;
WATSON, DD ;
BELLER, GA .
CIRCULATION, 1995, 91 (03) :813-820
[10]  
GO RT, 1990, J NUCL MED, V31, P1899