Abstract 14952: Automated Quantitative PET/CT Myocardial Perfusion Imaging: Normal Limits and Correlation with Invasive Coronary Angiography
Background: Computer algorithms for assessment of myocardial perfusion imaging with positron emission tomography/computed tomography (PET/CT) have been described, but there have been few reports of their accuracy for detecting coronary artery disease (CAD). We aimed to develop normal limits and determine the diagnostic accuracy of an automated quantification of 82Rb myocardial perfusion PET/CT for detection of coronary artery disease (CAD) (≥70% stenosis) in comparison to invasive coronary angiography (ICA).
Methods: We studied 103 patients undergoing PET/CT, including 61 consecutive patients (66% males, age 70 ± 12) without known CAD who had diagnostic ICA within 6 months of PET/CT (CATH) and 42 consecutive patients with a low likelihood of CAD (LLk). CT was used for attenuation correction. Normal limits for PET/CT perfusion, transient ischemic dilation (TID) ratio and stress induced ejection fraction (EF) drop (rest — stress EF) were created from studies of LLk patients. Automated software was used to quantify the perfusion abnormality expressed as total perfusion deficit (TPD). Stress TPD ≥5% myocardium was considered abnormal for per-patient analysis.
Results: From normal limits, the cutoff value was determined >1.28 for TID ratio, and >0% for stress induced EF drop. The area under the receiver operating characteristic curve was 0.87 for identification of ≥50% or ≥70% stenoses. On a per-patient basis, the sensitivity/specificity were respectively 84%/81% for detecting ≥50% stenosis, and 92%/74% for detecting ≥70% stenosis. In CATH population, 8 patients had TID (7 with more than 2 vessel disease) and 13 patients had EF drop (7 with more than 2 vessel disease), out of 38 patients who had ≥70% stenosis by ICA. None of the patients with ≥70% stenosis in CATH population, had TID or EF drop.
Conclusion: Automated quantification of 82Rb PET/CT shows high diagnostic accuracy for detecting clinically significant CAD.
- © 2010 by American Heart Association, Inc.