Diagnostic Accuracy of Rubidium-82 Myocardial Perfusion Imaging using PET CT

Normal Rubidium-82 Myocardial Perfusion PET-CT Study

Abnormal Rubidium-82 Myocardial Perfusion PET-CT Study

Limitations

May underestimate the anatomical extent of CAD in some patients with multivessel disease. Subclinical vessel disease may have normal perfusion studies. Not all patients with normal perfusion study get CTA or Cath. Adds bias to the true Negative group May underestimate the anatomical extent of CAD in some patients with multivessel disease. Subclinical vessel disease may have normal perfusion studies. Not all patients with normal perfusion study get CTA or Cath. Adds bias to the true Negative group

Advantage of ECG-gated PET Assess LV function at rest and during peak stress Healthy pts: LVEF increases during peak vasodilator stress Patients with left main or 3 vessel CAD show decrease in LVEF at peak stress even in the absence of perfusion abnormalities

Sensitivity 93% in single vessel disease. 92% in multivessel disease. May have a slight bias as many normals don’t have correlative coronary angiography. MDCT angiography shows high degree of correlation with Rubidium-82 Myocardial Perfusion PET-CT.

Integrated PET/CTA study

Integrated PET/CTA study: Noncalcified plaque (arrow) in proximal LAD with 50%–70% stenosis. However, rest and peak stress myocardial perfusion PET study (bottom left panel) demonstrates only minimal inferoapical ischemia.

Conclusion Myocardial perfusion PET-CT : high sensitivity for detection of CAD. applicable to both men and women, nonobese and obese patients. Patients with single-vessel as well as multivessel coronary disease. Rest and stress imaging is completed in approximately 25 min. Myocardial perfusion PET-CT : high sensitivity for detection of CAD. applicable to both men and women, nonobese and obese patients. Patients with single-vessel as well as multivessel coronary disease. Rest and stress imaging is completed in approximately 25 min.

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