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 |
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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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