Ahmed Fathala1, Mervat Aboulkheir1,2, Mohamamed M Shoukri3, Hani Alsergani4. 1. Department of Radiology, Nuclear Medicine and Cardiovascular Imaging, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. 2. Taibah University, Madinah, Saudi Arabia. 3. Department of Cell Biology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia. 4. King Faisal Heart Institute, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
Abstract
BACKGROUND: 13N-ammonia positron emission tomography-computed tomography (PET-CT) is being increasingly used as a non-invasive imaging modality for evaluating patients with known or suspected coronary artery disease (CAD), but information about the diagnostic accuracy of PET-MPI is sparse. Objectives: Our objective was to determine the accuracy of 13N-ammonia PET-CT myocardial perfusion imaging (MPI) for detecting CAD. METHODS: We retrospectively evaluated 383 patients with suspected CAD who underwent rest-stress 13N- ammonia PET-CT MPI. Invasive coronary angiography (ICA) was performed within 60 days for all patients with abnormal PET-MPI findings and for selected patients with normal PET-MPI findings. RESULTS: The mean age of the patients was 64±11 years, and the mean body mass index was 32±7 kg/m2. Stress perfusion defects were identified in 147 (34%) out of a total of 383 patients. ICA was performed in 213 patients (145 patients with abnormal PET and 68 patients with normal PET). The sensitivity of PET-MPI for detection of obstructive CAD based on ≥50% stenosis was 90%; specificity, 90%; positive predictive value, 96%; negative predictive value, 76%; and diagnostic accuracy, 80%. CONCLUSIONS: PET-MPI with 13N-ammonia affords high sensitivity and overall accuracy for detecting CAD. The addition of coronary artery calcium score (CACS) can improve CAD risk stratification.
BACKGROUND: 13N-ammonia positron emission tomography-computed tomography (PET-CT) is being increasingly used as a non-invasive imaging modality for evaluating patients with known or suspected coronary artery disease (CAD), but information about the diagnostic accuracy of PET-MPI is sparse. Objectives: Our objective was to determine the accuracy of 13N-ammonia PET-CT myocardial perfusion imaging (MPI) for detecting CAD. METHODS: We retrospectively evaluated 383 patients with suspected CAD who underwent rest-stress 13N- ammonia PET-CT MPI. Invasive coronary angiography (ICA) was performed within 60 days for all patients with abnormal PET-MPI findings and for selected patients with normal PET-MPI findings. RESULTS: The mean age of the patients was 64±11 years, and the mean body mass index was 32±7 kg/m2. Stress perfusion defects were identified in 147 (34%) out of a total of 383 patients. ICA was performed in 213 patients (145 patients with abnormal PET and 68 patients with normal PET). The sensitivity of PET-MPI for detection of obstructive CAD based on ≥50% stenosis was 90%; specificity, 90%; positive predictive value, 96%; negative predictive value, 76%; and diagnostic accuracy, 80%. CONCLUSIONS: PET-MPI with 13N-ammonia affords high sensitivity and overall accuracy for detecting CAD. The addition of coronary artery calcium score (CACS) can improve CAD risk stratification.
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