| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Clinical Investigations |
1 Nuclear Cardiology Section, Division of Cardiology, University Hospital, Zurich, Switzerland
2 Division of Nuclear Medicine, University Hospital, Zurich, Switzerland
An accurate, noninvasive technique for the diagnosis of coronary artery disease (CAD) should provide complementary information on coronary anatomy and pathophysiologic lesion severity. We present, what is to our knowledge, the first clinical evaluation of integrated PET/CT for combined acquisition of coronary anatomy and perfusion. Methods: On an integrated PET/CT scanner, contrast-enhanced CT angiography (CTA) and rest/adenosine-stress myocardial perfusion scanning with 13N-ammonia were performed on 25 patients with CAD documented by coronary angiography. Contrast-enhanced CTA was performed with retrospective electrocardiography gating after injection of 150 mL of intravenous contrast medium. Decisions on whether to treat with revascularization (anatomic lesion plus ischemia) or conservatively (no lesion or no ischemia) based on PET/CT were compared with those based on PET plus coronary angiography. Results: Of the 100 coronary artery segments (left main, left anterior descending, left circumflex, and right in 25 patients), 7 (in 5 patients) were considered impossible to evaluate by CT because of rapid vessel movement but were correctly categorized by PET alone. In the remaining 93 segments, the sensitivity and specificity of PET/CT versus PET plus coronary angiography were 90% and 98%, respectively. Positive and negative predictive values were 82% and 99%, and accuracy was 97%. Conclusion: The data of this preliminary study suggest that PET/CT allows accurate noninvasive clinical decision making about CAD. Because of its high negative predictive value, PET/CT may play an important role in noninvasive selection of CAD patients for revascularization. Integration of higher-performance multislice spiral CT scanners into PET/CT hybrids will accelerate the clinical implementation of this technique.
Key Words: hybrid PET/CT • coronary angiography • coronary artery disease • PET • CT
This article has been cited by other articles:
|
|
 |
|
  L. Husmann, B. A. Herzog, O. Gaemperli, F. Tatsugami, N. Burkhard, I. Valenta, P. Veit-Haibach, C. A. Wyss, U. Landmesser, and P. A. Kaufmann Diagnostic accuracy of computed tomography coronary angiography and evaluation of stress-only single-photon emission computed tomography/computed tomography hybrid imaging: comparison of prospective electrocardiogram-triggering vs. retrospective gating Eur. Heart J., March 1, 2009; 30(5): 600 - 607. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H Kuehl, H Eggebrecht, T Boes, G Antoch, S Rosenbaum, S Ladd, A Bockisch, J Barkhausen, and R Erbel Detection of inflammation in patients with acute aortic syndrome: comparison of FDG-PET/CT imaging and serological markers of inflammation Heart, November 1, 2008; 94(11): 1472 - 1477. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. K. Buck, S. Nekolla, S. Ziegler, A. Beer, B. J. Krause, K. Herrmann, K. Scheidhauer, H.-J. Wester, E. J. Rummeny, M. Schwaiger, et al. SPECT/CT J. Nucl. Med., August 1, 2008; 49(8): 1305 - 1319. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Schroeder, S. Achenbach, F. Bengel, C. Burgstahler, F. Cademartiri, P. de Feyter, R. George, P. Kaufmann, A. F. Kopp, J. Knuuti, et al. Cardiac computed tomography: indications, applications, limitations, and training requirements: Report of a Writing Group deployed by the Working Group Nuclear Cardiology and Cardiac CT of the European Society of Cardiology and the European Council of Nuclear Cardiology Eur. Heart J., February 2, 2008; 29(4): 531 - 556. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Husmann, I. Valenta, O. Gaemperli, O. Adda, V. Treyer, C. A. Wyss, P. Veit-Haibach, F. Tatsugami, G. K. von Schulthess, and P. A. Kaufmann Feasibility of low-dose coronary CT angiography: first experience with prospective ECG-gating Eur. Heart J., January 2, 2008; 29(2): 191 - 197. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Dewey, B. Hamm, H-P. Dubel, and W. Rutsch Multislice computed tomography coronary angiography for triaging patients with positive radionuclide myocardial perfusion imaging QJM, January 1, 2008; 101(1): 65 - 67. [Full Text] [PDF]
|
|
|
|
 |
|
 G. T. Wilson, P. Gopalakrishnan, and T. Tak Noninvasive Cardiac Imaging with Computed Tomography Clin. Med. Res., October 1, 2007; 5(3): 165 - 171. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Coceani and A. L'Abbate Role of delayed enhancement MRI in patients with acute coronary syndrome and unobstructed coronary arteries Eur. Heart J., October 1, 2007; 28(19): 2416 - 2417. [Full Text] [PDF]
|
|
|
|
|
|
O. Gaemperli, T. Schepis, I. Valenta, L. Husmann, H. Scheffel, V. Duerst, F. R. Eberli, T. F. Luscher, H. Alkadhi, and P. A. Kaufmann Cardiac Image Fusion from Stand-Alone SPECT and CT: Clinical Experience J. Nucl. Med., May 1, 2007; 48(5): 696 - 703. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Wijns Anatomic-Functional Imaging by Single-Photon Emission Computed Tomography/Computed Tomography as the Cornerstone of Diagnosis and Treatment for Coronary Patients: A Glimpse Into the (Near) Future? J. Am. Coll. Cardiol., March 13, 2007; 49(10): 1068 - 1070. [Full Text] [PDF]
|
|
|
|
|
|
S. Rispler, Z. Keidar, E. Ghersin, A. Roguin, A. Soil, R. Dragu, D. Litmanovich, A. Frenkel, D. Aronson, A. Engel, et al. Integrated Single-Photon Emission Computed Tomography and Computed Tomography Coronary Angiography for the Assessment of Hemodynamically Significant Coronary Artery Lesions J. Am. Coll. Cardiol., March 13, 2007; 49(10): 1059 - 1067. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J J Bax, R S Beanlands, F J Klocke, J Knuuti, A A Lammertsma, M A Schaefers, H R Schelbert, G K Von Schulthess, L J Shaw, G Z Yang, et al. Diagnostic and clinical perspectives of fusion imaging in cardiology: is the total greater than the sum of its parts? Heart, January 1, 2007; 93(1): 16 - 22. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Wagner, M. Anton, S. G. Nekolla, S. Reder, J. Henke, S. Seidl, R. Hegenloh, M. Miyagawa, R. Haubner, M. Schwaiger, et al. Noninvasive Characterization of Myocardial Molecular Interventions by Integrated Positron Emission Tomography and Computed Tomography J. Am. Coll. Cardiol., November 21, 2006; 48(10): 2107 - 2115. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Schepis, O. Gaemperli, P. Koepfli, I. Valenta, K. Strobel, A. Brunner, S. Leschka, L. Desbiolles, L. Husmann, H. Alkadhi, et al. Comparison of 64-Slice CT with Gated SPECT for Evaluation of Left Ventricular Function J. Nucl. Med., August 1, 2006; 47(8): 1288 - 1294. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. K. von Schulthess, H. C. Steinert, and T. F. Hany Integrated PET/CT: Current Applications and Future Directions Radiology, February 1, 2006; 238(2): 405 - 422. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Rimoldi, K. P. Schafers, R. Boellaard, F. Turkheimer, L. Stegger, M. P. Law, A. A. Lammerstma, and P. G. Camici Quantification of Subendocardial and Subepicardial Blood Flow Using 15O-Labeled Water and PET: Experimental Validation J. Nucl. Med., January 1, 2006; 47(1): 163 - 172. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. R. DeGrado, M. T. Kitapci, S. Wang, J. Ying, and G. D. Lopaschuk Validation of 18F-Fluoro-4-Thia-Palmitate as a PET Probe for Myocardial Fatty Acid Oxidation: Effects of Hypoxia and Composition of Exogenous Fatty Acids J. Nucl. Med., January 1, 2006; 47(1): 173 - 181. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Schwaiger, S. Ziegler, and S. G. Nekolla PET/CT: Challenge for Nuclear Cardiology J. Nucl. Med., October 1, 2005; 46(10): 1664 - 1678. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Wijns The Diagnosis of Coronary Artery Disease: In Search of a "One-Stop Shop"? J. Nucl. Med., June 1, 2005; 46(6): 904 - 905. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| JOURNAL OF NUCLEAR MEDICINE TECHNOLOGY | THE JOURNAL OF NUCLEAR MEDICINE |
