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Myocardial Viability Assessment by PET: 82Rb Defect Washout Does Not Predict the Results of Metabolic–Perfusion Mismatch

Mark A. Stankewicz, MD1, Craig S. Mansour, MD1, Robert L. Eisner, PhD2, Keith B. Churchwell, MD1, Byron R. Williams, MD1, Steven R. Sigman, MD1, James Streeter, CNMT1 and Randolph E. Patterson, MD1,2

1 Carlyle Fraser Heart Center, Emory Crawford Long Hospital, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
2 Department of Radiology, Emory University School of Medicine, Atlanta, Georgia



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  		FIGURE 1. Scatterplot shows poor correlation between percentage washout of 82Rb between early and late resting images and percentage mismatch between metabolism (18F-FDG) and perfusion (82Rb uptake) in 82Rb defect used for assessment of viability.

 


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  		FIGURE 2. Bar graph displays sensitivity (filled bars) and specificity (open bars) of 82Rb defect severity at various cut points when compared with viability using 18F-FDG–82Rb mismatch.

 


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  		FIGURE 3. Bar graph displays sensitivity (filled bars) and specificity (open bars) of 82Rb defect washout at various cut points when compared with viability using 18F-FDG–82Rb mismatch.

 


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  		FIGURE 4. Sensitivity and specificity of combined 82Rb severity and mismatch used to define viability when compared with viability assessment using 18F-FDG–82Rb mismatch.

 


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  		FIGURE 5. ROC curve compares 82Rb washout with 18F-FDG–82Rb.

 


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  		FIGURE 6. Patient 1 (short-axis slices): nonviable by 82Rb washout, viable by 18F-FDG–82Rb. Patient 2 (horizontal long-axis slices): viable by 82Rb washout, nonviable by 18F-FDG–82Rb.

 


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  		FIGURE 7. Bull’s-eye summary views of patients 1 and 2 shown in Figure 6.

 




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