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Published in: Journal of Nuclear Cardiology 6/2017

01-12-2017 | Debate Article

PET should replace SPECT in cardiac imaging for diagnosis and risk assessment of patients with known or suspected CAD: Pro

Authors: Jamshid Maddahi, MD, FACC, FASNC, René R. Sevag Packard, MD

Published in: Journal of Nuclear Cardiology | Issue 6/2017

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Excerpt

Positron emission tomography (PET) myocardial perfusion imaging (MPI) has been performed for the better part of 3 decades. Initially limited to academic centers and viewed with skepticism, it has gained greater acceptance as a test with improved ability to detect coronary artery disease (CAD) and improve patient risk stratification. Here, we will review how PET fares better than single-photon emission-computed tomography (SPECT) by comparing technical and radiotracer characteristics as well as clinical data. …
Literature
2.
go back to reference Maddahi J. Properties of an ideal PET perfusion tracer: New PET tracer cases and data. J Nucl Cardiol 2012;19:S30-7.CrossRefPubMed Maddahi J. Properties of an ideal PET perfusion tracer: New PET tracer cases and data. J Nucl Cardiol 2012;19:S30-7.CrossRefPubMed
3.
go back to reference Maddahi J, Udelson J, Heller GV, Lazewatsky J, Orlandi C. The first phase 3 international multicenter clinical trial of Flurpiridaz F 18, a new radiopharmaceutical for PET Myocardial perfusion imaging. J Nucl Cardiol 2015; Abstract. Maddahi J, Udelson J, Heller GV, Lazewatsky J, Orlandi C. The first phase 3 international multicenter clinical trial of Flurpiridaz F 18, a new radiopharmaceutical for PET Myocardial perfusion imaging. J Nucl Cardiol 2015; Abstract.
4.
go back to reference Maddahi J, Huang SC, Schiepers C, Bengel F, Czernin J, Schelbert HS, et al. Same day rest-stress protocols for PET imaging with the new F-18 labeled BMS747158 myocardial perfusion tracer. J Nucl Med 2009;50:1173. Maddahi J, Huang SC, Schiepers C, Bengel F, Czernin J, Schelbert HS, et al. Same day rest-stress protocols for PET imaging with the new F-18 labeled BMS747158 myocardial perfusion tracer. J Nucl Med 2009;50:1173.
5.
go back to reference Berman DS, Maddahi J, Tamarappoo BK, Czernin J, Taillefer R, Udelson JE, et al. Phase II safety and clinical comparison with single-photon emission computed tomography myocardial perfusion imaging for detection of coronary artery disease: Flurpiridaz F 18 positron emission tomography. J Am Coll Cardiol 2013;61:469-77.CrossRefPubMed Berman DS, Maddahi J, Tamarappoo BK, Czernin J, Taillefer R, Udelson JE, et al. Phase II safety and clinical comparison with single-photon emission computed tomography myocardial perfusion imaging for detection of coronary artery disease: Flurpiridaz F 18 positron emission tomography. J Am Coll Cardiol 2013;61:469-77.CrossRefPubMed
6.
go back to reference Slomka PJ, Berman DS, Germano G. New cardiac cameras: Single-photon emission CT and PET. Semin Nucl Med 2014;44:232-51.CrossRefPubMed Slomka PJ, Berman DS, Germano G. New cardiac cameras: Single-photon emission CT and PET. Semin Nucl Med 2014;44:232-51.CrossRefPubMed
7.
go back to reference Kaster T, Mylonas I, Renaud JM, Wells GA, Beanlands RS, deKemp RA. Accuracy of low-dose rubidium-82 myocardial perfusion imaging for detection of coronary artery disease using 3D PET and normal database interpretation. J Nucl Cardiol 2012;19:1135-45.CrossRefPubMed Kaster T, Mylonas I, Renaud JM, Wells GA, Beanlands RS, deKemp RA. Accuracy of low-dose rubidium-82 myocardial perfusion imaging for detection of coronary artery disease using 3D PET and normal database interpretation. J Nucl Cardiol 2012;19:1135-45.CrossRefPubMed
8.
go back to reference Senthamizhchelvan S, Bravo PE, Esaias C, Lodge MA, Merrill J, Hobbs RF, et al. Human biodistribution and radiation dosimetry of 82Rb. J Nucl Med 2010;51:1592-9.CrossRefPubMedPubMedCentral Senthamizhchelvan S, Bravo PE, Esaias C, Lodge MA, Merrill J, Hobbs RF, et al. Human biodistribution and radiation dosimetry of 82Rb. J Nucl Med 2010;51:1592-9.CrossRefPubMedPubMedCentral
9.
go back to reference Knuuti J. Integrated positron emission tomography/computed tomography (PET/CT) in coronary disease. Heart 2009;95:1457-63.CrossRefPubMed Knuuti J. Integrated positron emission tomography/computed tomography (PET/CT) in coronary disease. Heart 2009;95:1457-63.CrossRefPubMed
11.
go back to reference Maddahi J, Czernin J, Lazewatsky J, Huang SC, Dahlbom M, Schelbert H, et al. Phase I, first-in-human study of BMS747158, a novel 18F-labeled tracer for myocardial perfusion PET: Dosimetry, biodistribution, safety, and imaging characteristics after a single injection at rest. J Nucl Med 2011;52:1490-8.CrossRefPubMed Maddahi J, Czernin J, Lazewatsky J, Huang SC, Dahlbom M, Schelbert H, et al. Phase I, first-in-human study of BMS747158, a novel 18F-labeled tracer for myocardial perfusion PET: Dosimetry, biodistribution, safety, and imaging characteristics after a single injection at rest. J Nucl Med 2011;52:1490-8.CrossRefPubMed
12.
go back to reference Maddahi J, Bengel F, Czernin J, Crane P, Dahlbom M, Schelbert, HS, et al. Dosimetry, biodistribution, and safety of flurpiridaz F 18 in healthy subjects undergoing 2-day rest-stress PET myocardial perfusion imaging. J Nucl Cardiol. 2015 (in press). Maddahi J, Bengel F, Czernin J, Crane P, Dahlbom M, Schelbert, HS, et al. Dosimetry, biodistribution, and safety of flurpiridaz F 18 in healthy subjects undergoing 2-day rest-stress PET myocardial perfusion imaging. J Nucl Cardiol. 2015 (in press).
13.
go back to reference Maddahi J, Lazewatsky J, Udelson J, Orlandi C. Radiation dose to patients in a phase 3 trial of Flurpiridaz F18, a new radiopharmaceutical for PET Myocardial Perfusion Imaging. J Nucl Cardiol 2014; abstract. Maddahi J, Lazewatsky J, Udelson J, Orlandi C. Radiation dose to patients in a phase 3 trial of Flurpiridaz F18, a new radiopharmaceutical for PET Myocardial Perfusion Imaging. J Nucl Cardiol 2014; abstract.
14.
go back to reference Parker MW, Iskandar A, Limone B, Perugini A, Kim H, Jones C, et al. Diagnostic accuracy of cardiac positron emission tomography versus single photon emission computed tomography for coronary artery disease: A bivariate meta-analysis. Circ Cardiovasc Imaging 2012;5:700-7.CrossRefPubMed Parker MW, Iskandar A, Limone B, Perugini A, Kim H, Jones C, et al. Diagnostic accuracy of cardiac positron emission tomography versus single photon emission computed tomography for coronary artery disease: A bivariate meta-analysis. Circ Cardiovasc Imaging 2012;5:700-7.CrossRefPubMed
15.
go back to reference Mc Ardle BA, Dowsley TF, deKemp RA, Wells GA, Beanlands RS. Does rubidium-82 PET have superior accuracy to SPECT perfusion imaging for the diagnosis of obstructive coronary disease?: A systematic review and meta-analysis. J Am Coll Cardiol 2012;60:1828-37.CrossRefPubMed Mc Ardle BA, Dowsley TF, deKemp RA, Wells GA, Beanlands RS. Does rubidium-82 PET have superior accuracy to SPECT perfusion imaging for the diagnosis of obstructive coronary disease?: A systematic review and meta-analysis. J Am Coll Cardiol 2012;60:1828-37.CrossRefPubMed
16.
go back to reference Bateman TM, Heller GV, McGhie AI, Friedman JD, Case JA, Bryngelson JR, et al. Diagnostic accuracy of rest/stress ECG-gated Rb-82 myocardial perfusion PET: Comparison with ECG-gated Tc-99m sestamibi SPECT. J Nucl Cardiol 2006;13:24-33.CrossRefPubMed Bateman TM, Heller GV, McGhie AI, Friedman JD, Case JA, Bryngelson JR, et al. Diagnostic accuracy of rest/stress ECG-gated Rb-82 myocardial perfusion PET: Comparison with ECG-gated Tc-99m sestamibi SPECT. J Nucl Cardiol 2006;13:24-33.CrossRefPubMed
17.
go back to reference Schindler TH, Schelbert HR, Quercioli A, Dilsizian V. Cardiac PET imaging for the detection and monitoring of coronary artery disease and microvascular health. JACC Cardiovasc Imaging 2010;3:623-40.CrossRefPubMed Schindler TH, Schelbert HR, Quercioli A, Dilsizian V. Cardiac PET imaging for the detection and monitoring of coronary artery disease and microvascular health. JACC Cardiovasc Imaging 2010;3:623-40.CrossRefPubMed
18.
go back to reference Dorbala S, Vangala D, Sampson U, Limaye A, Kwong R, Di Carli MF. Value of vasodilator left ventricular ejection fraction reserve in evaluating the magnitude of myocardium at risk and the extent of angiographic coronary artery disease: A 82Rb PET/CT study. J Nucl Med 2007;48:349-58.PubMed Dorbala S, Vangala D, Sampson U, Limaye A, Kwong R, Di Carli MF. Value of vasodilator left ventricular ejection fraction reserve in evaluating the magnitude of myocardium at risk and the extent of angiographic coronary artery disease: A 82Rb PET/CT study. J Nucl Med 2007;48:349-58.PubMed
19.
go back to reference Bengel FM. Leaving relativity behind: Quantitative clinical perfusion imaging. J Am Coll Cardiol 2011;58:749-51.CrossRefPubMed Bengel FM. Leaving relativity behind: Quantitative clinical perfusion imaging. J Am Coll Cardiol 2011;58:749-51.CrossRefPubMed
20.
go back to reference Cremer P, Hachamovitch R, Tamarappoo B. Clinical decision making with myocardial perfusion imaging in patients with known or suspected coronary artery disease. Semin Nucl Med 2014;44:320-9.CrossRefPubMedPubMedCentral Cremer P, Hachamovitch R, Tamarappoo B. Clinical decision making with myocardial perfusion imaging in patients with known or suspected coronary artery disease. Semin Nucl Med 2014;44:320-9.CrossRefPubMedPubMedCentral
21.
go back to reference Fiechter M, Ghadri JR, Gebhard C, Fuchs TA, Pazhenkottil AP, Nkoulou RN, et al. Diagnostic value of 13 N-ammonia myocardial perfusion PET: Added value of myocardial flow reserve. J Nucl Med 2012;53:1230-4.CrossRefPubMed Fiechter M, Ghadri JR, Gebhard C, Fuchs TA, Pazhenkottil AP, Nkoulou RN, et al. Diagnostic value of 13 N-ammonia myocardial perfusion PET: Added value of myocardial flow reserve. J Nucl Med 2012;53:1230-4.CrossRefPubMed
22.
go back to reference Naya M, Murthy VL, Taqueti VR, Foster CR, Klein J, Garber M, et al. Preserved coronary flow reserve effectively excludes high-risk coronary artery disease on angiography. J Nucl Med 2014;55:248-55.CrossRefPubMedPubMedCentral Naya M, Murthy VL, Taqueti VR, Foster CR, Klein J, Garber M, et al. Preserved coronary flow reserve effectively excludes high-risk coronary artery disease on angiography. J Nucl Med 2014;55:248-55.CrossRefPubMedPubMedCentral
23.
go back to reference Packard RR, Huang SC, Dahlbom M, Czernin J, Maddahi J. Absolute quantitation of myocardial blood flow in human subjects with or without myocardial ischemia using dynamic flurpiridaz F 18 PET. J Nucl Med 2014;55:1438-44.CrossRefPubMedPubMedCentral Packard RR, Huang SC, Dahlbom M, Czernin J, Maddahi J. Absolute quantitation of myocardial blood flow in human subjects with or without myocardial ischemia using dynamic flurpiridaz F 18 PET. J Nucl Med 2014;55:1438-44.CrossRefPubMedPubMedCentral
24.
go back to reference Ben-Haim S, Murthy VL, Breault C, Allie R, Sitek A, Roth N, et al. Quantification of Myocardial perfusion reserve using dynamic SPECT imaging in humans: A feasibility study. J Nucl Med 2013;54:873-9.CrossRefPubMedPubMedCentral Ben-Haim S, Murthy VL, Breault C, Allie R, Sitek A, Roth N, et al. Quantification of Myocardial perfusion reserve using dynamic SPECT imaging in humans: A feasibility study. J Nucl Med 2013;54:873-9.CrossRefPubMedPubMedCentral
25.
go back to reference Kay J, Dorbala S, Goyal A, Fazel R, Di Carli MF, Einstein AJ, et al. Influence of sex on risk stratification with stress myocardial perfusion Rb-82 positron emission tomography: Results from the PET (Positron Emission Tomography) Prognosis Multicenter Registry. J Am Coll Cardiol 2013;62:1866-76.CrossRefPubMed Kay J, Dorbala S, Goyal A, Fazel R, Di Carli MF, Einstein AJ, et al. Influence of sex on risk stratification with stress myocardial perfusion Rb-82 positron emission tomography: Results from the PET (Positron Emission Tomography) Prognosis Multicenter Registry. J Am Coll Cardiol 2013;62:1866-76.CrossRefPubMed
26.
go back to reference Chow BJ, Dorbala S, Di Carli MF, Merhige ME, Williams BA, Veledar E, et al. Prognostic value of PET myocardial perfusion imaging in obese patients. JACC Cardiovasc Imaging 2014;7:278-87.CrossRefPubMed Chow BJ, Dorbala S, Di Carli MF, Merhige ME, Williams BA, Veledar E, et al. Prognostic value of PET myocardial perfusion imaging in obese patients. JACC Cardiovasc Imaging 2014;7:278-87.CrossRefPubMed
27.
go back to reference Herzog BA, Husmann L, Valenta I, Gaemperli O, Siegrist PT, Tay FM, et al. Long-term prognostic value of 13 N-ammonia myocardial perfusion positron emission tomography added value of coronary flow reserve. J Am Coll Cardiol 2009;54:150-6.CrossRefPubMed Herzog BA, Husmann L, Valenta I, Gaemperli O, Siegrist PT, Tay FM, et al. Long-term prognostic value of 13 N-ammonia myocardial perfusion positron emission tomography added value of coronary flow reserve. J Am Coll Cardiol 2009;54:150-6.CrossRefPubMed
28.
go back to reference Fukushima K, Javadi MS, Higuchi T, Lautamaki R, Merrill J, Nekolla SG, et al. Prediction of short-term cardiovascular events using quantification of global myocardial flow reserve in patients referred for clinical 82Rb PET perfusion imaging. J Nucl Med 2011;52:726-32.CrossRefPubMed Fukushima K, Javadi MS, Higuchi T, Lautamaki R, Merrill J, Nekolla SG, et al. Prediction of short-term cardiovascular events using quantification of global myocardial flow reserve in patients referred for clinical 82Rb PET perfusion imaging. J Nucl Med 2011;52:726-32.CrossRefPubMed
29.
go back to reference Ziadi MC, Dekemp RA, Williams KA, Guo A, Chow BJ, Renaud JM, et al. Impaired myocardial flow reserve on rubidium-82 positron emission tomography imaging predicts adverse outcomes in patients assessed for myocardial ischemia. J Am Coll Cardiol 2011;58:740-8.CrossRefPubMed Ziadi MC, Dekemp RA, Williams KA, Guo A, Chow BJ, Renaud JM, et al. Impaired myocardial flow reserve on rubidium-82 positron emission tomography imaging predicts adverse outcomes in patients assessed for myocardial ischemia. J Am Coll Cardiol 2011;58:740-8.CrossRefPubMed
31.
go back to reference Murthy VL, Naya M, Foster CR, Hainer J, Gaber M, Di Carli G, et al. Improved cardiac risk assessment with noninvasive measures of coronary flow reserve. Circulation 2011;124:2215-24.CrossRefPubMedPubMedCentral Murthy VL, Naya M, Foster CR, Hainer J, Gaber M, Di Carli G, et al. Improved cardiac risk assessment with noninvasive measures of coronary flow reserve. Circulation 2011;124:2215-24.CrossRefPubMedPubMedCentral
32.
go back to reference Murthy VL, Naya M, Foster CR, Gaber M, Hainer J, Klein J, et al. Association between coronary vascular dysfunction and cardiac mortality in patients with and without diabetes mellitus. Circulation 2012;126:1858-68.CrossRefPubMedPubMedCentral Murthy VL, Naya M, Foster CR, Gaber M, Hainer J, Klein J, et al. Association between coronary vascular dysfunction and cardiac mortality in patients with and without diabetes mellitus. Circulation 2012;126:1858-68.CrossRefPubMedPubMedCentral
33.
go back to reference Taqueti VR, Hachamovitch R, Murthy VL, Naya M, Foster CR, Hainer J, et al. Global coronary flow reserve is associated with adverse cardiovascular events independently of luminal angiographic severity and modifies the effect of early revascularization. Circulation 2015;131:19-27.CrossRefPubMed Taqueti VR, Hachamovitch R, Murthy VL, Naya M, Foster CR, Hainer J, et al. Global coronary flow reserve is associated with adverse cardiovascular events independently of luminal angiographic severity and modifies the effect of early revascularization. Circulation 2015;131:19-27.CrossRefPubMed
Metadata
Title
PET should replace SPECT in cardiac imaging for diagnosis and risk assessment of patients with known or suspected CAD: Pro
Authors
Jamshid Maddahi, MD, FACC, FASNC
René R. Sevag Packard, MD
Publication date
01-12-2017
Publisher
Springer US
Published in
Journal of Nuclear Cardiology / Issue 6/2017
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-015-0300-7

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