Cardiac positron emission tomography/computed tomography imaging accurately detects anatomically and functionally...

Area of Science:

• Cardiology
• Radiology
• Nuclear Medicine

Background:

• Computed tomography (CT) is widely used for coronary artery disease (CAD) detection, but stenosis evaluation can be uncertain.
• Perfusion imaging is crucial for identifying ischemia and guiding treatment.
• Hybrid positron emission tomography (PET)/CT offers combined angiography and perfusion imaging in efficient, quantitative, low-dose protocols.

Purpose of the Study:

• To evaluate the accuracy of cardiac hybrid PET/CT for noninvasive detection of coronary artery disease.
• To compare the diagnostic performance of hybrid PET/CT with CT angiography and perfusion imaging alone against invasive angiography.

Main Methods:

• 107 patients with intermediate pretest likelihood of CAD underwent quantitative PET/(15)O-water and CT angiography using hybrid PET/CT.
• Results were validated against invasive angiography, including fractional flow reserve measurements where applicable.
• Radiation doses for prospective triggering and spiral CT protocols were recorded.

Main Results:

• Hybrid PET/CT achieved 98% accuracy in detecting coronary artery disease, significantly outperforming CT angiography alone (81% PPV) and perfusion imaging alone.
• Both PET/CT and CT angiography showed a 97% negative predictive value.
• Radiation doses were low, with a mean of 9.3 mSv for prospective triggering protocols.

Conclusions:

• Cardiac hybrid PET/CT provides accurate noninvasive diagnosis of coronary artery disease in symptomatic individuals.
• The imaging modality is feasible for routine clinical use.
• Most patients can undergo the procedure with less than 10 mSv radiation exposure.