title: Clinical performance of Rb-82 myocardial perfusion PET and Tc-99m-based SPECT in patients with extreme obesity.
abstract: We evaluated the performance of stress imaging with technetium-99m-labeled tetrofosmin single-photon emission computed tomography (SPECT) and rubidium-82 positron emission tomography (PET) in patients with extreme obesity, defined as body mass index ≥40 kg/m2.
  
  
  
  We identified patients with extreme obesity who underwent angiography in our center and either stress SPECT or PET within the previous six months. Cohorts of patients with extreme obesity and a <5% pretest likelihood of CAD who underwent SPECT (N = 25) or PET (N = 25) were also included.
  
  
  
  In total, 108 patients who underwent SPECT (N = 57) or PET (N = 51) were identified. Scan interpretation was classified as definitely normal or abnormal in 83.3% of PET and 60.5% of SPECT scans, respectively (P < .01). PET demonstrated higher diagnostic accuracy and normalcy rate. PET was found to have higher specificity for the pooled cohort. Similar findings were observed using stenosis cut-offs of ≥50% and ≥70%.
  
  
  
  In patients with extreme obesity, PET enabled more definitive scan interpretation with less artifact compared to SPECT. PET provided higher diagnostic accuracy and specificity in the detection of obstructive coronary artery disease.
authors.affiliation: Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: David T
authors.initials: DT
authors.lastname: Harnett
authors.affiliation: Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Samir
authors.initials: S
authors.lastname: Hazra
authors.affiliation: CAPITAL Research Group, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada.
authors.forename: Ronnen
authors.initials: R
authors.lastname: Maze
authors.affiliation: Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Mc Ardle
authors.affiliation: Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Ali
authors.initials: A
authors.lastname: Alenazy
authors.affiliation: CAPITAL Research Group, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada.
authors.forename: Trevor
authors.initials: T
authors.lastname: Simard
authors.affiliation: Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Ellen
authors.initials: E
authors.lastname: Henry
authors.affiliation: Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Girish
authors.initials: G
authors.lastname: Dwivedi
authors.affiliation: CAPITAL Research Group, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada.
authors.forename: Christopher
authors.initials: C
authors.lastname: Glover
authors.affiliation: Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Robert A
authors.initials: RA
authors.lastname: deKemp
authors.affiliation: Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Ross A
authors.initials: RA
authors.lastname: Davies
authors.affiliation: Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Terrence D
authors.initials: TD
authors.lastname: Ruddy
authors.affiliation: Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Benjamin J W
authors.initials: BJW
authors.lastname: Chow
authors.affiliation: Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Rob S
authors.initials: RS
authors.lastname: Beanlands
authors.affiliation: CAPITAL Research Group, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada. bhibbert@ottawaheart.ca.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Hibbert
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D009767:Obesity, Morbid / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D012042:Registries; D012414:Rubidium Radioisotopes; D012680:Sensitivity and Specificity; D013667:Technetium; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D012414:Rubidium Radioisotopes; D013667:Technetium; C000615479:Rubidium-82
keywords: Myocardial perfusion imaging; PET/CT; SPECT; obesity