15-O-water myocardial flow reserve PET and CT angiography by full hybrid PET/CT as a potential alternative to invasive angiography

Autor: Poul Flemming Høilund-Carlsen, Poul-Erik Braad, Anders Thomassen, Lisette Okkels Jensen, Allan Johansen, Kasper Pedersen, Axel Cosmus Pyndt Diederichsen, Hans Mickley, Henrik Petersen, Juhani Knuuti, Oke Gerke
Rok vydání: 2018
Předmět:
Male
Computed Tomography Angiography
PET 15-O-water
Coronary Vessels/diagnostic imaging
Coronary Artery Disease
030204 cardiovascular system & hematology
Coronary Angiography
030218 nuclear medicine & medical imaging
Coronary artery disease
0302 clinical medicine
Oxygen Radioisotopes
Positron Emission Tomography Computed Tomography
Prospective Studies
Diagnostic value
Cardiac imaging
Aged
80 and over

Observer Variation
Computed Tomography Angiography/methods
medicine.diagnostic_test
Myocardial Perfusion Imaging
Middle Aged
Coronary Vessels
Reproducibility
Myocardial Perfusion Imaging/methods
Invasive coronary angiography
CT angiography
Predictive value of tests
Female
Cardiology and Cardiovascular Medicine
Coronary Artery Disease/diagnostic imaging
Adult
Oxygen Radioisotopes/administration & dosage
03 medical and health sciences
Multidetector Computed Tomography/methods
Predictive Value of Tests
Coronary Circulation
Multidetector Computed Tomography
medicine
Humans
Radiology
Nuclear Medicine and imaging

Aged
Coronary Angiography/methods
Flow reserve
PET-CT
business.industry
Reproducibility of Results
medicine.disease
Confidence interval
Angiography
business
Nuclear medicine
Positron Emission Tomography Computed Tomography/methods
Zdroj: Thomassen, A, Braad, P-E, Pedersen, K T, Petersen, H, Johansen, A, Diederichsen, A C P, Mickley, H, Jensen, L O, Knuuti, J, Gerke, O & Høilund-Carlsen, P F 2018, ' 15-O-water myocardial flow reserve PET and CT angiography by full hybrid PET/CT as a potential alternative to invasive angiography ', The international journal of cardiovascular imaging, vol. 34, no. 12, pp. 2011–2022 . https://doi.org/10.1007/s10554-018-1420-3
ISSN: 1573-0743
1569-5794
DOI: 10.1007/s10554-018-1420-3
Popis: Combined myocardial flow reserve (MFR) by PET and CT coronary angiography (CTA) is a promising tool for assessment of coronary artery disease. Prior analyses of MFR/CTA has been performed as side-by-side interpretation, not as volume rendered, full hybrid analysis, with fused MFR/CTA. We aimed to: (i) establish a method for full hybrid analysis of MFR/CTA, (ii) validate the inter- and intra-observer reproducibility of MFR values, and (iii) determine the diagnostic value of side-by-side versus full hybrid MFR/CTA with 15-O-water PET. Forty-four outpatients scheduled for invasive coronary angiography (ICA) were enrolled prospectively. All underwent rest/stress 15-O-water PET/CTA with ICA as reference. Within two observers of different experience, the Pearson r at global and territorial level exceeded 0.953 for rest, stress, and MFR values, as determined by Carimas software. Within and between observers, the mean differences between rest, stress, and MFR values were close to zero and the confidence intervals for 95% limits of agreement were narrow. The diagnostic performance of full hybrid PET/CTA did not outperform the side-by-side approach, but performed better than MFR without CTA at vessel level: specificity 93% (95% confidence limits: 89-97%) versus 76% (64-88%), p = 0.0004; positive predictive value 71% (55-86%) versus 51% (37-65%), p = 0.0001; accuracy 90% (84-95%) versus 77% (69-84%), p = 0.0009. MFR showed high reproducibility within and between observers of different experience. The full hybrid model was not superior to side-by-side interpretation of MFR/CTA, but proved better than MFR alone at vessel level with regard to specificity, positive predictive value, and accuracy.
Databáze: OpenAIRE
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