Diagnostic Accuracy of Cardiac Positron Emission Tomography Versus Single Photon Emission Computed Tomography for Coronary Artery Disease

Parker, Matthew W.; Iskandar, Aline; Limone, Brendan; Perugini, Andrew; Kim, Hye-Jin; Jones, Charles M.; Calamari, Brian; Coleman, Craig I.; Heller, Gary V.

doi:10.1161/circimaging.112.978270

Cited by 217 publications

(94 citation statements)

References 30 publications

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“…Here, a close collaboration of nuclear medicine physicians, radiologists, and cardiologists is In cardiology, PET imaging is still most frequently used for the diagnosis of obstructive CAD. This method yields high sensitivity and specificity of about 90% (38)(39)(40) and is of proven value for accurate prognosis and good patient management (41)(42)(43). In particular, the extent of ischemia as determined by PET myocardial perfusion imaging has prognostic implications when patients are assigned to the optimal therapy, either revascularization or intensified medical therapy (44).…”

Section: Workflow Considerationsmentioning

confidence: 99%

Hybrid PET/MR Imaging of the Heart: Potential, Initial Experiences, and Future Prospects

et al. 2013

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Learning Objectives: On successful completion of this activity, participants should be able to describe (1) advantages and shortcomings of hybrid PET/MR scanners with respect to cardiovascular applications (e.g. myocardial perfusion imaging and viability imaging), (2) additional value of the MR component in cardiac imaging, and (3) technical challenges and workflow considerations regarding hybrid PET/MR scanners in the field of cardiology (e.g. attenuation correction and cardiac/respiratory/patient motion).Financial Disclosure: Dr. Schwaiger is an investigator, meeting participant, and lecturer for Siemens Medical. The authors of this article have indicated no other relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, participants can access this activity through the SNMMI Web site (http:// www.snmmi.org/ce_online) through March 2016.PET/CT and other combined scanners have in the past decade rapidly emerged as important research tools and are proving to be invaluable for improved diagnostics in routine nuclear medicine. The design of hybrid PET/MR scanners presented a formidable technical challenge, and only recently were these instruments introduced to the market. Initial expectations of the performance of these scanners have been high, notably because of the potential for superior tissue contrast inherent in the MR modality, as well as the potential for multiparametric functional imaging in conjunction with PET. However, the additional value and potential clinical role that these new systems might bring to the cardiac field have yet to be documented. This review presents a comparative summary of the existing applications for PET and MR in the field of cardiology and suggests potential cardiac applications exploiting unique properties of the newly introduced combined instrumentation. The diverse range of imaging modalities for cardiology includes echocardiography, CT, MR imaging, SPECT, and PET, each of which offers distinct properties and advantages. The demand for combined PET/CT instrumentation in clinical nuclear medicine has grown remarkably, because of the notable advantages presented by hybrid imaging with respect to anatomic localization of lesions. Although these advantages were initially driven by the demands of oncology imaging, the resultant broader availability of PET/CT has provided the opportunity to use these scanners for indications beyond oncology, such as in the field of cardiac imaging (1). Furthermore, CT images are necessary for rapid attenuation correction, which is of particular importance for quantification in myocardial perfusion imaging. Through the use of suitable CT components a...

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Section: Workflow Considerationsmentioning

confidence: 99%

Hybrid PET/MR Imaging of the Heart: Potential, Initial Experiences, and Future Prospects

et al. 2013

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“…Despite our awareness of and our many publications on its limitations, visual interpretation of coronary stenosis on angiogram was used as a reference standard for binary classification of our study population into significant or nonsignificant coronary artery stenosis, similar to all previous reports on diagnostic accuracy of SPECT MPI in the literature and in widespread clinical practice (37,38).…”

Section: Systolic Imagesmentioning

confidence: 75%

Clinical Utility of Enhanced Relative Activity Recovery on Systolic Myocardial Perfusion SPECT: Lessons from PET

et al. 2015

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SPECT and PET myocardial perfusion images show greater myocardial intensity and homogeneity in systole than diastole because of greater systolic myocardial thickness, less partial volume loss, and enhanced activity recovery. Consequently, conventional myocardial perfusion images obtained from whole cardiac cycles have lower myocardial intensity and greater heterogeneity than systolic images. Considering relative activity distribution on SPECT systolic images may add clinical utility to whole-cycle images and wall motion. Methods: Patients undergoing coronary angiogram within 4 mo after SPECT myocardial perfusion imaging were reviewed. Images were interpreted by 2 masked interpreters using a 17-segment, 5-point scale to determine summed rest scores (SSS), summed stress scores, and summed difference scores on conventional and systolic images in 603 patients (55.6% no coronary artery disease [no-CAD] and 44.4% CAD). Studies were considered normal when the SSS was less than 4 and summed difference score was less than 2. Results: In the no-CAD group, systolic SSS was lower than SSS from conventional images (2 ± 2.3 vs. 3 ± 2.6, P , 0.001). In contrast, SSS derived from systolic and conventional images were not different in the obstructive CAD group (9.1 ± 7.6 vs. 9.2 ± 7.4, P 5 0.559). When systolic images were considered, true-negative studies increased from 27.2% to 43.3% (P , 0.001) whereas false-positive studies decreased from 28.4% to 12.3% (P , 0.001). True-positive (38% vs. 37.2%, P 5 0.505) and false-negative studies (6.5% vs. 7%, P 5 0.450) were not significantly changed. Diagnostic accuracy increased from 65.2% to 80.8% (P , 0.001). Conclusion: For gated SPECT myocardial perfusion imaging, when relative activity distribution on systolic images was considered, false-positive studies were reduced and diagnostic accuracy was improved.

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“…These methods are non-invasive, safe, possess high diagnostic value and enable prediction of the adverse cardiac events [10].…”

Section: Introductionmentioning

confidence: 99%

Bilateral coronary artery to pulmonary trunk fistulae detected by coronary angiography and evaluated by ECG-gated SPECT myocardial perfusion imaging: report of two cases

Pachowicz

Drozd²,

Belz

et al. 2014

Folia Morphol

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Coronary artery fistulae (CAF) are anomalies related to coronary artery abnormaltermination. This is a very rare congenital malformation accounting for about 0.2-0.4% of congenital cardiac anomalies, but in some patients it can be haemodynamically important. Single-photon emission computed tomography or positron emission tomography myocardial perfusion imaging (MPI) using radioactive agents is widely used in clinical practice for cardiac ischaemia detection as a very sensitive and non-invasive tool.We are going to present 2 patients with bilateral CAFs to the pulmonary trunk without signs of the rest or stress ischaemia in MPI. (Folia Morphol 2014; 73, 4: 514-520)

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Diagnostic Accuracy of Cardiac Positron Emission Tomography Versus Single Photon Emission Computed Tomography for Coronary Artery Disease

Abstract: In a meta-analysis of 11,862 patients, PET MPI demonstrated a higher sensitivity for coronary artery disease than SPECT MPI. No difference in specificity was detected in the pooled analysis of PET and SPECT MPI.

Cited by 217 publications

References 30 publications

Hybrid PET/MR Imaging of the Heart: Potential, Initial Experiences, and Future Prospects

Hybrid PET/MR Imaging of the Heart: Potential, Initial Experiences, and Future Prospects

Clinical Utility of Enhanced Relative Activity Recovery on Systolic Myocardial Perfusion SPECT: Lessons from PET

Bilateral coronary artery to pulmonary trunk fistulae detected by coronary angiography and evaluated by ECG-gated SPECT myocardial perfusion imaging: report of two cases

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