Potential utility of rubidium 82 PET quantification in patients with 3-vessel coronary artery disease.
BACKGROUND
Standard perfusion imaging may underestimate the extent of disease in 3-vessel coronary atherosclerosis. This study determined whether positron emission tomography quantification of perfusion reserve by use of rubidium 82 net retention defined a greater extent of disease than the standard approach in patients with 3-vessel disease.


RESULTS
Rb-82 net retention was quantified as an estimation of absolute perfusion at rest and with dipyridamole stress by use of dynamic positron emission tomography imaging. The percent of abnormal myocardial sectors, as compared with a normal database, for a standard and quantification approach was determined. Twenty-three patients were evaluated. Defect sizes were larger in patients with 3-vessel disease (n = 13) by use of quantification methods: 44% +/- 18% of the myocardial sectors were abnormal by use of the standard approach versus 69% +/- 24% of sectors when measured by quantification of the stress-rest perfusion difference (P =.008). In patients with single-vessel disease (n = 10), defect sizes were smaller with quantification methods.


CONCLUSIONS
Quantification of Rb-82 net retention to measure the stress-rest perfusion difference in the myocardium defined a greater extent of disease than the standard approach in this group of patients with triple-vessel disease. More accurate measurement of the extent of coronary artery disease could facilitate better risk stratification and identify more high-risk patients in whom aggressive intervention is required.
Cardiac PET Center, Department of Medicine, University of Ottawa Heart Institute, Ontario, Canada.
R
R
Parkash
R A
RA
deKemp
T D
TD
Ruddy
A
A
Kitsikis
R
R
Hart
L
L
Beauchesne
L
L
Beauschene
Kathryn
K
Williams
R A
RA
Davies
M
M
Labinaz
R S B
RS
Beanlands
D000368:Aged; D003324:Coronary Artery Disease / Q000145:classification* / Q000150:complications / Q000000981:diagnostic imaging*; D004176:Dipyridamole; D005080:Exercise Test; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012414:Rubidium Radioisotopes; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014055:Tomography, Emission-Computed / Q000379:methods; D018487:Ventricular Dysfunction, Left / Q000145:classification* / Q000000981:diagnostic imaging* / Q000209:etiology
D019275:Radiopharmaceuticals; D012414:Rubidium Radioisotopes; D004176:Dipyridamole