Quantitative (82)Rb PET/CT: development and validation of myocardial perfusion database

Area of Science:

• Nuclear Medicine
• Cardiovascular Imaging
• Diagnostic Accuracy

Background:

• Myocardial perfusion (82)Rb PET/CT is increasingly used for diagnosing coronary artery disease (CAD).
• The diagnostic accuracy of database quantification methods for CAD using (82)Rb PET/CT has not been well-established.
• There is a need for validated quantitative tools to support the interpretation of these studies.

Purpose of the Study:

• To develop and validate a sex-independent normal database and criteria for abnormality in rest-stress (82)Rb PET/CT myocardial perfusion imaging.
• To assess the accuracy of this quantitative database for the diagnosis of CAD.

Main Methods:

• Developed and validated a sex-independent normal database using rest-adenosine stress (82)Rb PET/CT in 281 patients.
• Patients were categorized into healthy, pilot, and validation groups.
• Prospective validation involved comparison with coronary angiography in a subset of patients.

Main Results:

• The quantitative database achieved an overall accuracy of 91% for detecting CAD (≥50% stenosis).
• Sensitivity for CAD detection was 93%, and specificity was 75%.
• High accuracy was observed for individual coronary arteries, with 100% for the right coronary artery.

Conclusions:

• The validated quantitative (82)Rb PET/CT database is highly accurate for detecting and localizing CAD.
• Quantitative outputs from these algorithms can serve as valuable decision support tools for physicians.
• This tool aids in the interpretation of myocardial perfusion imaging for CAD diagnosis.