Abstract
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Objectives Flurpiridaz F 18 is a novel PET myocardial perfusion imaging (MPI) tracer. In this multi-center Phase 2 study, rest-stress flurpiridaz F 18 PET and SPECT MPI were compared for evaluation of stress induced myocardial perfusion abnormalities in patients (Pts) with coronary artery disease (CAD).
Methods 84 Pts from 21 centers, underwent coronary angiography and rest-stress flurpiridaz F 18 PET (PET) and SPECT MPI. Tc-99m labeled tracer was used for all stress and 81% of rest SPECT. The mean age of Pts was 64.5 years (range: 36-85) and 68 were males. In each Pt, 17 myocardial segments were visually scored on rest and stress images by 3 independent, blinded readers. For each Pt, summed difference scores (SDS) were determined from segmental scores. Percent narrowing in each coronary artery was quantitatively and blindly determined and ≥50% luminal diameter narrowing was considered significant. Of the 84 Pts, 52 had CAD and 32 had insignificant CAD or normal coronary arteries.
Results There were 105 diseased coronary arteries in 52 patients; 40 left anterior descending, 30 left circumflex and 35 right coronary arteries. In patients with at least one diseased artery, the mean±SD PET SDS score ranged among the three readers from 6.8±5.75 to 9.4±7.51 and the SPECT SDS score ranged from 4.1±4.75 to 5.7±6.51. The differences in SDS scores between PET and SPECT were statistically significant in all readers (p<0.01). In 52 patients with multivessel disease, the adjusted mean PET SDS score was significantly higher than that of SPECT SDS score (p<0.001).
Conclusions These data suggest that as compared to Tc-99m SPECT, flurpiridaz F 18 PET MPI demonstrates more severe and extensive stress induced perfusion abnormalities in myocardial regions that are supplied by diseased coronary arteries and in patients with multivessel CAD.
Research Support Lantheus Medical Imagin
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