title: Accuracy of low-dose rubidium-82 myocardial perfusion imaging for detection of coronary artery disease using 3D PET and normal database interpretation.
abstract: BACKGROUND
  Our aim was to develop a normal database to be used for quantification of myocardial perfusion and diagnosis of "obstructive coronary artery disease" (CAD) using low-dose rubidium-82 three-dimensional (3D) positron emission tomography (PET)-CT.
  
  
  METHODS
  From a record of 1,501 patients, 77 were identified as having low-likelihood (LLK) of CAD. Forty LLK patients were used to construct a normal database using 4DM-PET, the remainder used for validation of normalcy. A group of 70 patients with CAD who had invasive coronary angiography and PET-CT were used to evaluate the accuracy of the database for detecting CAD using the sum-stress-score. The effect of clinical exclusion criteria and the inclusion of LLK patients were evaluated.
  
  
  RESULTS
  The normal database for CAD detection had a normalcy rate of 95%. Sensitivity was 100% for detecting patients with either 50% or 70% stenosis. Optimal specificity was 87% for either 50% or 70% stenosis. For localizing disease at 50% stenosis in the left anterior descending, left circumflex, and right coronary artery, sensitivity ranged from 59% to 68%, while specificity was maintained at 87-89%. Similarly, at 70% stenosis, sensitivity ranged from 64% to 79%, and specificity from 87% to 91%.
  
  
  CONCLUSIONS
  A normal database containing the relative perfusion scores of patients with LLK of CAD can be used to accurately diagnose obstructive coronary disease using low-dose Rb-82 with 3D PET-CT imaging.
authors.affiliation: The National Cardiac PET Centre and Cardiac Research Methods Centre, Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada.
authors.forename: Tyler
authors.initials: T
authors.lastname: Kaster
authors.forename: Ilias
authors.initials: I
authors.lastname: Mylonas
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Renaud
authors.forename: George A
authors.initials: GA
authors.lastname: Wells
authors.forename: Rob S B
authors.initials: RS
authors.lastname: Beanlands
authors.forename: Robert A
authors.initials: RA
authors.lastname: deKemp
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D055414:Myocardial Perfusion Imaging; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D012372:ROC Curve; D019275:Radiopharmaceuticals; D012414:Rubidium Radioisotopes; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D012414:Rubidium Radioisotopes