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Automated quantitative Rb-82 3D PET/CT myocardial perfusion imaging: normal limits and correlation with invasive
Ryo Nakazato1, Daniel S Berman, Damini Dey
1Departments of Imaging and Medicine, and Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Background:
We aimed to characterize normal limits and to determine the diagnostic accuracy for an automated quantification of 3D 82-Rubidium (Rb-82) PET/CT myocardial perfusion imaging (MPI).
Methods:
We studied 125 consecutive patients undergoing Rb-82 PET/CT MPI, including patients with suspected coronary artery disease (CAD) and invasive coronary angiography, and 42 patients with a low likelihood (LLk) of CAD. Normal limits for perfusion and function were derived from LLk patients. QPET software was used to quantify perfusion abnormality at rest and stress expressed as total perfusion deficit (TPD).
Results:
Relative perfusion databases did not differ in any of the 17 segments between males and females. The areas under the receiver operating characteristic curve for detection of CAD were 0.86 for identification of ≥50% and ≥70% stenosis. The sensitivity/specificity was 86%/86% for detecting ≥50% stenosis and 93%/77% for ≥70% stenosis, respectively. In regard to normal limits, mean rest and stress left ventricular ejection fraction (LVEF) were 67% ± 10% and 75% ± 9%, respectively. Mean transient ischemic dilation ratio was 1.06 ± 0.14 and mean increase in LVEF with stress was 7.4% ± 6.1% (95th percentile of 0%).
Conclusion:
Normal limits have been established for 3D Rb-82 PET/CT analysis with QPET software. Fully automated quantification of myocardial perfusion PET data shows high diagnostic accuracy for detecting obstructive CAD.
Insights
Automated 3D Rubidium-82 (Rb-82) PET/CT myocardial perfusion imaging (MPI) establishes normal limits and demonstrates high accuracy for detecting coronary artery disease (CAD). This quantitative analysis aids in diagnosing obstructive CAD with QPET software.
Area of Science:
- Nuclear Cardiology
- Cardiovascular Imaging
- Quantitative Analysis
Background:
- Myocardial perfusion imaging (MPI) using 3D Rubidium-82 (Rb-82) PET/CT is a key diagnostic tool.
- Automated quantification methods require established normal limits for accurate interpretation.
- Coronary artery disease (CAD) diagnosis relies on precise assessment of myocardial blood flow.
Purpose of the Study:
- To establish normal limits for 3D Rb-82 PET/CT MPI.
- To evaluate the diagnostic accuracy of automated quantification using QPET software.
- To assess the software's ability to detect obstructive coronary artery disease.
Main Methods:
- Studied 125 patients with suspected CAD and 42 with low likelihood (LLk) of CAD undergoing Rb-82 PET/CT MPI.
- Derived normal perfusion and function limits from LLk patients.
- Utilized QPET software for automated quantification of total perfusion deficit (TPD) at rest and stress.
Main Results:
- No significant differences in relative perfusion between males and females across 17 segments.
- Area under the ROC curve for CAD detection was 0.86 for ≥50% and ≥70% stenosis.
- Sensitivity/specificity for ≥50% stenosis: 86%/86%; for ≥70% stenosis: 93%/77%.
Conclusions:
- Normal limits for 3D Rb-82 PET/CT analysis with QPET software have been successfully established.
- Fully automated quantification of myocardial perfusion PET data demonstrates high diagnostic accuracy.
- This automated approach is effective for detecting obstructive CAD.
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