Document Detail


Quantitative (82)Rb PET/CT: development and validation of myocardial perfusion database.
MedLine Citation:
PMID:  17574973     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The use of myocardial perfusion (82)Rb PET/CT studies continues to increase but its accuracy using database quantification methods for the diagnosis of coronary artery disease (CAD) has not been established. METHODS: A sex-independent normal database and criteria for abnormality for rest-stress (82)Rb PET/CT myocardial perfusion imaging were developed and validated by evaluation of 281 patients (136 females: mean age +/- SD, 63.3 +/- 13.3 y; 145 males: mean age +/- SD, 63.9 +/- 12.8 y) who underwent a rest-adenosine stress (82)Rb PET/CT study. These patients were divided into 3 groups: (a) healthy group: 30 patients, with <5% likelihood of CAD (low likelihood [LLK]) based on sequential Bayesian analysis; these patients were used to generate the normal distribution; (b) pilot group: 174 patients; these patients were used to determine the optimal criteria for detecting and localizing the perfusion abnormality; and (c) validation group: 76 patients (23 with LLK of CAD and 53 who underwent coronary angiography; these patients were used for prospective validation. RESULTS: Of the 53 patients who underwent coronary angiography, 8 had <50% stenosis and 45 patients had at least one stenosis > or =50% in one major artery. Fifteen patients had single-vessel disease, 17 had double-vessel disease, and 13 had triple-vessel disease. The prospective validation shows a normalcy rate of 78% (18/23) for global CAD. The analyses by individual arteries show a normalcy rate of 96% (22/23) for the left anterior descending coronary artery, 96% for the left circumflex coronary artery (22/23), and 100% for the right coronary artery (23/23). The overall sensitivity for detection of CAD (> or =50% stenosis) was 93% (42/45). The overall specificity for detection of the absence of CAD (< or =50% stenosis) was 75% (6/8). Also, the positive predictive value for global CAD was 95% (42/44), the negative predictive value was 67% (6/9), and the accuracy was 91% (48/53). CONCLUSION: The quantitative (82)Rb PET/CT database created and validated in this study is highly accurate for the detection and localization of CAD. Physicians should consider using the quantitative output of these algorithms as decision support tools to aid with image interpretation.
Authors:
Cesar A Santana; Russell D Folks; Ernest V Garcia; Liudmila Verdes; Rupan Sanyal; Jon Hainer; Marcelo F Di Carli; Fabio P Esteves
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2007-06-15
Journal Detail:
Title:  Journal of nuclear medicine : official publication, Society of Nuclear Medicine     Volume:  48     ISSN:  0161-5505     ISO Abbreviation:  J. Nucl. Med.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-07-03     Completed Date:  2007-08-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0217410     Medline TA:  J Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1122-8     Citation Subset:  IM    
Affiliation:
Emory University School of Medicine, Atlanta, Georgia 30322, USA. csantan@emory.edu
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MeSH Terms
Descriptor/Qualifier:
Coronary Artery Disease / radiography,  radionuclide imaging*
Coronary Circulation
Databases, Factual*
Female
Humans
Image Interpretation, Computer-Assisted
Male
Middle Aged
Positron-Emission Tomography / methods
Radiopharmaceuticals / diagnostic use*
Reference Values
Rubidium Radioisotopes / diagnostic use*
Tomography, X-Ray Computed / methods
Grant Support
ID/Acronym/Agency:
K01 HL70422/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 0/Rubidium Radioisotopes

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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