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82Rb PET myocardial perfusion imaging is superior to 99mTc-labelled agent SPECT in patients with known or suspected coronary artery disease

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 28 August 2012

Abstract

Purpose

We compared the quality, interpretive confidence and interreader agreement between SPECT and PET myocardial perfusion imaging (MPI) in the same group of patients.

Methods

The study group comprised 27 patients (age 55 ± 8.5 years, 12 men) with known or suspected coronary artery disease (CAD) who had undergone gated rest/stress MPI with 99mTc-labelled agent SPECT (with and without attenuation correction, AC), and subsequent clinical confirmation with 82Rb PET. Three experienced readers blinded to the clinical information interpreted all MPI studies.

Results

Interreader agreement was significantly superior for PET studies than for SPECT studies. Following consensus interpretation, the quality of 22 % of the non-AC SPECT studies, 33 % of the AC SPECT studies and 63 % of the PET studies was assessed as excellent or good (p = 0.016). Interpretations were definitely normal or abnormal in 7 % of non-AC SPECT studies, 30 % of AC SPECT studies and 85 % of PET studies (p = 0.046). In 13 patients who had received either invasive coronary angiography or CT angiography with no significant CAD, the true-positive rate for significant CAD was higher for PET, and the true-negative rate was equal for PET and AC SPECT, and lower for non-AC SPECT.

Conclusion

82Rb PET MPI, used as a confirmatory test after SPECT, offers improved image quality, interpretive confidence and interreader agreement.

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Acknowledgments

This work was partially financed by a grant from MIA-HSCSP, Barcelona, Spain.

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Authors and Affiliations

  1. Division of Nuclear Medicine, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Albert Flotats, Paco E. Bravo, Kenji Fukushima, Muhammad A. Chaudhry, Jennifer Merrill & Frank M. Bengel

  2. Nuclear Medicine Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Sant Antoni M. Claret, 167, 08025, Barcelona, Spain

    Albert Flotats

  3. Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany

    Frank M. Bengel

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  1. Albert Flotats
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  2. Paco E. Bravo
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  3. Kenji Fukushima
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  4. Muhammad A. Chaudhry
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  5. Jennifer Merrill
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  6. Frank M. Bengel
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Correspondence to Albert Flotats.

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Flotats, A., Bravo, P.E., Fukushima, K. et al. 82Rb PET myocardial perfusion imaging is superior to 99mTc-labelled agent SPECT in patients with known or suspected coronary artery disease. Eur J Nucl Med Mol Imaging 39, 1233–1239 (2012). https://doi.org/10.1007/s00259-012-2140-x

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  • DOI: https://doi.org/10.1007/s00259-012-2140-x

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