Journal of Nuclear Cardiology

, Volume 26, Issue 1, pp 275–283 | Cite as

Clinical performance of Rb-82 myocardial perfusion PET and Tc-99m-based SPECT in patients with extreme obesity

  • David T. Harnett
  • Samir Hazra
  • Ronnen Maze
  • Brian A. Mc Ardle
  • Ali Alenazy
  • Trevor Simard
  • Ellen Henry
  • Girish Dwivedi
  • Christopher Glover
  • Robert A. deKemp
  • Ross A. Davies
  • Terrence D. Ruddy
  • Benjamin J. W. Chow
  • Rob S. Beanlands
  • Benjamin HibbertEmail author
Original Article



We evaluated the performance of stress imaging with technetium-99m-labeled tetrofosmin single-photon emission computed tomography (SPECT) and rubidium-82 positron emission tomography (PET) in patients with extreme obesity, defined as body mass index ≥40 kg/m2.


We identified patients with extreme obesity who underwent angiography in our center and either stress SPECT or PET within the previous six months. Cohorts of patients with extreme obesity and a <5% pretest likelihood of CAD who underwent SPECT (N = 25) or PET (N = 25) were also included.


In total, 108 patients who underwent SPECT (N = 57) or PET (N = 51) were identified. Scan interpretation was classified as definitely normal or abnormal in 83.3% of PET and 60.5% of SPECT scans, respectively (P < .01). PET demonstrated higher diagnostic accuracy and normalcy rate. PET was found to have higher specificity for the pooled cohort. Similar findings were observed using stenosis cut-offs of ≥50% and ≥70%.


In patients with extreme obesity, PET enabled more definitive scan interpretation with less artifact compared to SPECT. PET provided higher diagnostic accuracy and specificity in the detection of obstructive coronary artery disease.


Myocardial perfusion imaging PET/CT SPECT obesity 



Attenuation correction


Body mass index


Coronary artery bypass grafting


Coronary artery disease


Percutaneous coronary intervention


Positron emission tomography




Single-photon emission computed tomography





The authors would like to thank Lyanne Fuller BSc and Ann Guo BEng for their assistance with data collection, as well as May Aung CNMT, Kim Gardner CNMT, Patty Irvine CNMT, Monique Pacquette RN, and Patricia Grant RN.


SH reports receiving an honorarium from GE Healthcare. BM was a research fellow support by the Molecular Function and Imaging Heart and Stroke Foundation of Ontario Program Grant (No. PRG6242) and The University of Ottawa Heart Institute’s Whit & Heather Tucker Endowed Research Fellowship in Cardiology Award. BC is University of Ottawa Heart Institute Goldfarb Chair in Cardiac Imaging. RdK is a consultant for and has received grant funding from Jubilant DraxImage. RdK receives revenues from Rubidium-82 generator technology licensed to Jubilant DraxImage and from sales of FlowQuant software. TR has collaborated with and received research funding from GE Healthcare, Advanced Accelerator Applications, and AstraZeneca. BC has received grants from CV Diagnostix and research support from TeraRecon. RB is a Career Investigator supported by the Heart and Stroke Foundation of Canada; the University of Ottawa Heart Institute Vered Chair in Cardiology, and Tier 1 Chair in Cardiovascular Research from the University of Ottawa. RB is or has been a consultant for and receives grant funding from GE Healthcare, Lantheus Medical Imaging, Jubilant DraxImage. None of the other authors had disclosures relevant to this work.

Supplementary material

12350_2017_855_MOESM1_ESM.pptx (849 kb)
Supplementary material 1 (PPTX 849 kb)


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Copyright information

© American Society of Nuclear Cardiology 2017

Authors and Affiliations

  • David T. Harnett
    • 1
  • Samir Hazra
    • 1
  • Ronnen Maze
    • 2
  • Brian A. Mc Ardle
    • 1
  • Ali Alenazy
    • 1
  • Trevor Simard
    • 2
  • Ellen Henry
    • 1
  • Girish Dwivedi
    • 1
  • Christopher Glover
    • 2
  • Robert A. deKemp
    • 1
  • Ross A. Davies
    • 1
  • Terrence D. Ruddy
    • 1
  • Benjamin J. W. Chow
    • 1
  • Rob S. Beanlands
    • 1
  • Benjamin Hibbert
    • 2
    Email author
  1. 1.Division of Cardiology, Department of MedicineUniversity of Ottawa Heart InstituteOttawaCanada
  2. 2.CAPITAL Research Group, Division of Cardiology, Department of MedicineUniversity of Ottawa Heart InstituteOttawaCanada

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