Potential utility of rubidium 82 PET quantification in patients with 3-vessel coronary artery disease

Parkash, Ratika; deKemp, Robert A.; Ruddy, Terrence D.; Kitsikis, Anne; Hart, Robert G.; Beauschene, L.; Williams, Kathryn; Davies, Ross A.; Labinaz, Marino; Beanlands, Robert

doi:10.1016/j.nuclcard.2004.04.005

Cited by 255 publications

(178 citation statements)

References 33 publications

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“…[85][86][87] • In general, hyperemic MBF and MFR are relatively preserved for coronary lesions with less than 70% angiographic stenosis or with preserved fractional flow reserve (FFR) ([ 0.8). 45,47,51,52,[85][86][87][88][89]91,141,142 However, both Figure 7. Receiver-operator characteristic curves for detection of severe CAD using MFR.…”

Section: Reporting Quantitative Mbf Datamentioning

confidence: 94%

“…Stress-first or stress-only imaging is feasible, but it is not routine practice with quantitative PET. Although several studies have suggested that peak hyperemic MBF is superior to MFR, [45][46][47] most studies have concluded that MFR is more powerful for risk stratification, [48][49][50][51][52][53] perhaps because of decreased variability compared with peak hyperemic MBF. 54 Whether postischemic stunning affects resting MBF with stressfirst imaging has not been well studied.…”

Section: Imaging Protocolsmentioning

confidence: 99%

“…A global hyperemic MBF of more than 2 mL/minute/g and MFR of more than 2 reliably exclude the presence of high-risk angiographic CAD (negative predictive value [ 95%). 51,52,91 • A severely reduced global hyperemic MBF and MFR identify patients at high risk for major adverse cardiovascular events, including death. Although thresholds may vary in different labs using different software, in general an MFR of less than 1.5 should be considered a high-risk feature on MPI PET 46,49,50,53,92,94,98,102 and is associated with an Figure 8.…”

Section: Reporting Quantitative Mbf Datamentioning

confidence: 99%

“…51,52,91 In these patients, angiographic evaluation may be necessary to exclude disease that can potentially by revascularized. 98 • A severe reduction in hyperemic MBF (\ 1.5 mL/ minute/g) or MFR (\ 1.5) in a single vascular territory in a patient with normal MPI PET results by semiquantitative visual analysis should raise the possibility of flow-limiting CAD.…”

Section: Reporting Quantitative Mbf Datamentioning

confidence: 99%

See 3 more Smart Citations

Clinical Quantification of Myocardial Blood Flow Using PET: Joint Position Paper of the SNMMI Cardiovascular Council and the ASNC

Murthy

Bateman²,

Beanlands

et al. 2018

Journal of Nuclear Cardiology

173

111

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Section: Reporting Quantitative Mbf Datamentioning

confidence: 94%

Section: Imaging Protocolsmentioning

confidence: 99%

Section: Reporting Quantitative Mbf Datamentioning

confidence: 99%

Section: Reporting Quantitative Mbf Datamentioning

confidence: 99%

See 2 more Smart Citations

Clinical Quantification of Myocardial Blood Flow Using PET: Joint Position Paper of the SNMMI Cardiovascular Council and the ASNC

Murthy

Bateman²,

Beanlands

et al. 2018

Journal of Nuclear Cardiology

173

111

View full text Add to dashboard Cite

“…Measurement of MBF and coronary-flow reserve provides information on both the macro-and the micro-circulation and likely more accurate detection of both early and advanced disease [5][6][7]. Do these technical advantages and improved accuracy justify the use of PET in clinical routine?…”

mentioning

confidence: 99%

Should we use more PET-CT in clinical cardiology?

Knuuti

2008

Eur J Nucl Med Mol Imaging

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Recently, positron emission tomography (PET) has been increasingly used also in clinical cardiac imaging. The newest development, the hybrid imaging devices with 64-slice computed tomography (CT), have become available aiming specifically to cardiac imaging and has made this technique very attractive alternative to single photon emission computed tomography (SPECT) imaging.There are several advantages of PET as compared to SPECT. The perfusion imaging protocols with PET are faster due to shorter half-lives of the tracers and allow more efficient patient throughput. The radiation dose for the patients is only fraction of the doses provided by 99m Tc and 201 Tl, at least when 15 O-water or 13 NH 3 are used. The image artifacts are less common, the attenuation correction is well established and less susceptible to technical problems. These technical advantages have shown to increase the specificity and accuracy in detection of coronary artery disease (CAD) [1][2][3][4]. The higher spatial resolution and heart-to-background ratios seem to lead improved detection of small perfusion defects and, thus, to higher sensitivity. Currently, PET imaging has been primarily suggested to be used in difficult patient populations such as obese and diabetic subjects.The unique characteristic of PET is that it allows noninvasive quantification of myocardial blood flow (MBF) and metabolism. Measurement of MBF and coronary-flow reserve provides information on both the macro-and the micro-circulation and likely more accurate detection of both early and advanced disease [5][6][7]. Do these technical advantages and improved accuracy justify the use of PET in clinical routine? Myocardial perfusion SPECT has a huge amount of evidence supporting its robustness and accuracy in the detection of CAD, and its prognostic value is proven. The strengths and limitations of the technique are well known. Experienced staff is existing to deliver high quality service worldwide. It is obvious that to overtake the role of SPECT perfusion imaging is not an easy task for any technique.The limitations of PET are also currently obvious. While the availability of scanners is rapidly improving, the tracer production remains a major bottleneck. Without large multi-centre trials documenting the improved accuracy leading to improved patient care or cost savings, the justification of wider use of PET is difficult. Subsequently, without wider utilisation of the technique, new investments to PET tracer production are not sustainable.In the current issue of this journal, Siegrist et al.[8] investigated the impact of 13 N-ammonia myocardial PET perfusion imaging on clinical decision-making and the costeffectiveness in 100 consecutive patients with high likelihood of CAD or known CAD. The patient management decisions were assessed without and with the knowledge of PET results. The authors found that the management changed in 78 patients of 100 using PET perfusion information. In addition, the final clinical management decisions were in agreement with the PET finding...

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Gated Positron Emission Tomography for the Assessment of Myocardial Perfusion and Function

Macháč¹

2006

Clinical Gated Cardiac SPECT

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Potential utility of rubidium 82 PET quantification in patients with 3-vessel coronary artery disease

Cited by 255 publications

References 33 publications

Clinical Quantification of Myocardial Blood Flow Using PET: Joint Position Paper of the SNMMI Cardiovascular Council and the ASNC

Clinical Quantification of Myocardial Blood Flow Using PET: Joint Position Paper of the SNMMI Cardiovascular Council and the ASNC

Should we use more PET-CT in clinical cardiology?

Gated Positron Emission Tomography for the Assessment of Myocardial Perfusion and Function

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