Detection of coronary collaterals using dipyridamole PET myocardial perfusion imaging with rubidium-82.
This study evaluated the ability of dipyridamole PET myocardial perfusion imaging to detect coronary collaterals. A previous study showed an association between dipyridamole-induced coronary steal on PET imaging and the presence of coronary collaterals on angiography.


METHODS
Dipyridamole PET myocardial perfusion imaging using 82Rb was performed in 45 patients who had recent coronary angiography. The stress/rest count ratio (rubidium activity with stress divided by activity at rest)-was used to express the change in regional tracer uptake with dipyridamole and was calculated manually and automatically. The accuracy of the stress/rest count ratio for detecting coronary collaterals was determined.


RESULTS
A manual stress/rest count ratio < or = 0.80 identified coronary collaterals with 81% sensitivity, 92% specificity and 90% accuracy (p < 0.0001). An automated ratio < or = 0.80 had 90% sensitivity, 88% specificity and 90% accuracy (p < 0.0001). Vascular beds incorrectly identified by PET as having collaterals had an increased frequency of severe stenoses and abnormal wall motion.


CONCLUSIONS
PET perfusion imaging using the stress/rest count ratio can serve as a unique imaging method to identify coronary collaterals noninvasively.
Garza
D
D
Department of Medicine, Beth Israel Medical Center, New York, New York 10003, USA.
Tosh
A V
AV
Roberti
R
R
Dalal
P
P
Reimers
C
C
Ongseng
F
F
Ventura
B
B
Pompliano
J
J
Horowitz
S F
SF
D003097:Collateral Circulation; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D004176:Dipyridamole; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012414:Rubidium Radioisotopes; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed; D014665:Vasodilator Agents
D012414:Rubidium Radioisotopes; D014665:Vasodilator Agents; D004176:Dipyridamole