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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 5/2008

01-05-2008 | Original article

13N-ammonia myocardial perfusion imaging with a PET/CT scanner: impact on clinical decision making and cost-effectiveness

Authors: Patrick T. Siegrist, Lars Husmann, Martina Knabenhans, Oliver Gaemperli, Ines Valenta, Tobias Hoefflinghaus, Hans Scheffel, Paul Stolzmann, Hatem Alkadhi, Philipp A. Kaufmann

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 5/2008

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Abstract

Purpose

The purpose of the study is to determine the impact of 13N-ammonia positron emission tomography (PET) myocardial perfusion imaging (MPI) on clinical decision making and its cost-effectiveness.

Materials and methods

One hundred consecutive patients (28 women, 72 men; mean age 60.9 ± 12.0 years; range 24-85 years) underwent 13N-ammonia PET scanning (and computed tomography, used only for attenuation correction) to assess myocardial perfusion in patients with known (n = 79) or suspected (n = 8) coronary artery disease (CAD), or for suspected small-vessel disease (SVD; n = 13). Before PET, the referring physician was asked to determine patient treatment if PET would not be available. Four weeks later, PET patient management was reassessed for each patient individually.

Results

Before PET management strategies would have been: diagnostic angiography (62 of 100 patients), diagnostic angiography and percutaneous coronary intervention (PCI; 6 of 100), coronary artery bypass grafting (CABG; 3 of 100), transplantation (1 of 100), or conservative medical treatment (28 of 100). After PET scanning, treatment strategies were altered in 78 patients leading to: diagnostic angiography (0 of 100), PCI (20 of 100), CABG (3 of 100), transplantation (1 of 100), or conservative medical treatment (76 of 100). Patient management followed the recommendations of PET findings in 97% of the cases. Cost-effectiveness analysis revealed lower costs of €206/patient as a result of PET scanning.

Conclusion

In a population with a high prevalence of known CAD, PET is cost-effective and has an important impact on patient management.
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Metadata
Title
13N-ammonia myocardial perfusion imaging with a PET/CT scanner: impact on clinical decision making and cost-effectiveness
Authors
Patrick T. Siegrist
Lars Husmann
Martina Knabenhans
Oliver Gaemperli
Ines Valenta
Tobias Hoefflinghaus
Hans Scheffel
Paul Stolzmann
Hatem Alkadhi
Philipp A. Kaufmann
Publication date
01-05-2008
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 5/2008
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-007-0647-3

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