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Comparative Study
. 2021 Dec;28(6):2827-2839.
doi: 10.1007/s12350-020-02129-w. Epub 2020 May 7.

Quantification of myocardial perfusion reserve by CZT-SPECT: A head to head comparison with 82Rubidium PET imaging

Wanda Acampa  1   2 , Emilia Zampella  1 , Roberta Assante  1 , Andrea Genova  1 , Giovanni De Simini  1 , Teresa Mannarino  1 , Adriana D'Antonio  1 , Valeria Gaudieri  1 , Carmela Nappi  1 , Pietro Buongiorno  1 , Ciro Gabriele Mainolfi  3 , Mario Petretta  4 , Alberto Cuocolo  1
Affiliations
Comparative Study

Quantification of myocardial perfusion reserve by CZT-SPECT: A head to head comparison with 82Rubidium PET imaging

Wanda Acampa et al. J Nucl Cardiol. 2021 Dec.

Abstract

Background: We measured myocardial blood flow (MBF) and perfusion reserve (MPR) by dynamic CZT-SPECT and 82Rb-PET in patients with suspected or known coronary artery disease (CAD) and compared the accuracy of the two methods in predicting obstructive CAD.

Methods: Twenty-five patients with available coronary angiography data underwent 99mTc-sestamibi CZT-SPECT and 82Rb-PET cardiac imaging. Stress and rest MBF and MPR were calculated by both methods and compared. Diagnostic accuracies of CZT-SPECT and PET were also assessed using a receiver-operator-characteristic curve.

Results: CZT-SPECT yielded similar baseline MBF, but higher hyperemic MBF and MPR values compared to PET. There was a modest correlation between the two methods for MPR (r = 0.56, P < .01). MPR by CZT-SPECT showed a good ability in identify a reduced MPR by PET, with an area under the curve of 0.85. A MPR cut-off of 2.5 was identified by CZT-SPECT for detection of abnormal MPR by PET, with a sensitivity, specificity and accuracy of 86%, 73% and 80%. The area under the curve for the identification of obstructive CAD by regional MPR were 0.83 for CZT-SPECT and 0.84 for PET (P = .90). At CZT-SPECT, a regional MPR of 2.1 provided the best trade-off between sensitivity and specificity for identifying obstructive CAD. Diagnostic accuracy of CZT-SPECT and PET using respective cut-off values was comparable (P = .62).

Conclusion: Hyperemic MBF and MPR values obtained by CZT-SPECT are higher than those measured by 82Rb-PET imaging, with a moderate correlation between the two methods. CZT-SPECT shows good diagnostic accuracy for the identification of obstructive CAD. These findings may encourage the use of this new technique to a better risk stratification and patient management.

Keywords: CAD; Diagnostic and prognostic application; Myocardial blood flow; PET; SPECT.

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References

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