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FIGURE 4. Examples of improved diagnostic reliability of PET vs. SPECT MPI in the same patients. (A) A 70-y-old man status post CABG with no history of MI. Exercise/rest SPECT images are normal but left ventricular ejection fraction was surprisingly reduced at 0.39. PET MPI within 2 wk discloses a clinically occult posterobasal MI. (B) A 53-y-old man with exertional left arm pain. SPECT images with dipyridamole stress are normal. PET MPI within 2 wk demonstrates a reversible inferoseptal perfusion defect. Ninety percent circumflex stenosis found on coronary arteriography. (C) A 46-y-old woman with chest pain. SPECT images are equivocal for reversible ischemia in inferolateral wall. PET images are normal. (D) A 59-y-old woman with chest pain. SPECT images are equivocal for reversible inferolateral ischemia as in C. PET images demonstrate reversible inferoseptal perfusion defect, treated with PTCI of 95% dominant right coronary artery stenosis.
