Published in:
01-06-2020 | Original Article
Head-to-head comparison of the diagnostic performances of Rubidium-PET and SPECT with CZT camera for the detection of myocardial ischemia in a population of women and overweight individuals
Authors:
Fabien Hyafil, MD, PhD, Renata Chequer, MD, Emmanuel Sorbets, MD, PhD, Candice Estellat, MD, PhD, Gregory Ducrocq, MD, PhD, François Rouzet, MD, PhD, Toni Alfaiate, MSc, Hamza Regaieg, MD, Jérémie Abtan, MD, Sébastien Leygnac, PhD, Milan Milliner, MSc, Laetitia Imbert, PhD, Samuel Burg, MD, PhD, Rana Ben Azzouna, PharmD, PhD, Louis Potier, MD, Cédric Laouénan, MD, PhD, Caroline Quintin, MSc, Ronan Roussel, MD, PhD, Agnès Hartemann, MD, PhD, Gilles Montalescot, MD, PhD, Pierre-Yves Marie, MD, PhD, Gabriel Steg, MD, Dominique Le Guludec, MD, PhD
Published in:
Journal of Nuclear Cardiology
|
Issue 3/2020
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Abstract
Background
The aim of this study was to compare the diagnostic performances for the detection of myocardial ischemia of 82-Rb-PET-MPS and 99m-Tc-SPECT-MPS in overweight individuals and women.
Methods and Results
Men with BMI ≥ 25 and women referred for MPS were considered for inclusion. All individuals underwent 99m-Tc-SPECT-MPS with CZT cameras and 82-Rb-PET-MPS in 3D-mode. Individuals with at least one positive MPS were referred for coronary angiography (CA) with FFR measurements. A criterion for positivity was a composite endpoint including significant stenosis on CA or, in the absence of CA, the occurrence of acute coronary event during the following year. 313 patients (46% women) with mean BMI of 31.8 ± 6.5 were included. Sensitivity for the detection of myocardial ischemia was higher with 82-Rb-PET-MPS compared with 99m-Tc-SPECT-MPS (85% vs. 57%, P < .05); specificity was equally high with both imaging techniques (93% vs. 94%, P > .05). 82-Rb-PET allowed for a more accurate detection of patients with a high-risk coronary artery disease (HR-CAD) than 99m-Tc-SPECT-MPS (AUC = 0.86 vs. 0.75, respectively; P = .04).
Conclusions
In women and overweight individuals, 82-Rb-PET-MPS provides higher sensitivity for the detection of myocardial ischemia than 99m-Tc-SPECT-MPS thanks to a better image quality and an improved detection of HR-CAD.