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

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.

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Abbreviations

CA:

Coronary angiography

CAD:

Coronary artery disease

CZT:

Cadmium-Zinc-Telluride

FFR:

Fractional flow reserve

MBq:

Mega-Becquerel

MPS:

Myocardial perfusion scintigraphy

SPECT:

Single Photon Emission Computed Tomography

PET:

Positron Emission Tomography

82-Rubidium:

82-Rb

99m-Tc:

99m-Technetium

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Acknowledgments

We wish to thank Souad Bani, Naima Beldjoudi, Lucile Collas, Audrey Pépin, and Sabrina Salhi who supported us in the setup and monitoring of the RUBIS study (from URC Paris Nord Val de Seine, Assistance Publique – Hôpitaux de Paris, DRCI, Paris, France), and patients who agreed to participate in this study.

Disclosures

Fabien Hyafil is consultant for Naogen and Curium, Dominique Le Guludec is consultant for Advanced Accelerator Applications. The authors Renata Chequer, Emmanuel Sorbets, Candice Estellat, Gregory Ducrocq, François Rouzet, Toni Alfaiate, Hamza Regaieg, Jérémie Abtan, Sébastien Leygnac, Milan Milliner, Laetitia Imbert, Samuel Burg, Rana Ben Azzouna, Louis Potier, Cédric Laouénan, Caroline Quintin, Ronan Roussel, Agnès Hartemann, Gilles Montalescot, Pierre-Yves Marie, Gabriel Steg have nothing to disclose in relation to this manuscript.

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Correspondence to Fabien Hyafil MD, PhD.

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Funding This study was fully supported by a grant from the French Ministry of Health (Programme Hospitalier de Recherche Clinique 2011 AOM11066).

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Hyafil, F., Chequer, R., Sorbets, E. et al. 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. J. Nucl. Cardiol. 27, 755–768 (2020). https://doi.org/10.1007/s12350-018-01557-z

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Keywords

  • SPECT
  • MPI
  • Diagnostic and prognostic application
  • Myocardial blood flow
  • CAD
  • PET
  • 82-Rubidium
  • CZT camera