⁸²Rb PET myocardial perfusion imaging is superior to ⁹⁹mTc-labelled agent SPECT in patients with known or suspected coronary artery disease.
OBJECTIVE
We compared the quality, interpretive confidence and interreader agreement between SPECT and PET myocardial perfusion imaging (MPI) in the same group of patients.


METHODS
The study group comprised 27 patients (age 55 ± 8.5 years, 12 men) with known or suspected coronary artery disease (CAD) who had undergone gated rest/stress MPI with (99m)Tc-labelled agent SPECT (with and without attenuation correction, AC), and subsequent clinical confirmation with (82)Rb PET. Three experienced readers blinded to the clinical information interpreted all MPI studies.


RESULTS
Interreader agreement was significantly superior for PET studies than for SPECT studies. Following consensus interpretation, the quality of 22 % of the non-AC SPECT studies, 33 % of the AC SPECT studies and 63 % of the PET studies was assessed as excellent or good (p = 0.016). Interpretations were definitely normal or abnormal in 7 % of non-AC SPECT studies, 30 % of AC SPECT studies and 85 % of PET studies (p = 0.046). In 13 patients who had received either invasive coronary angiography or CT angiography with no significant CAD, the true-positive rate for significant CAD was higher for PET, and the true-negative rate was equal for PET and AC SPECT, and lower for non-AC SPECT.


CONCLUSIONS
(82)Rb PET MPI, used as a confirmatory test after SPECT, offers improved image quality, interpretive confidence and interreader agreement.
Division of Nuclear Medicine, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA. aflotats@santpau.cat
Albert
A
Flotats
Paco E
PE
Bravo
Kenji
K
Fukushima
Muhammad A
MA
Chaudhry
Jennifer
J
Merrill
Frank M
FM
Bengel
D000328:Adult; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007553:Isotope Labeling; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D015609:Organotechnetium Compounds; D049268:Positron-Emission Tomography / Q000379:methods*; D012414:Rubidium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
D015609:Organotechnetium Compounds; D012414:Rubidium Radioisotopes