PT  - JOURNAL ARTICLE
AU  - Fiechter, Michael
AU  - Ghadri, Jelena R.
AU  - Gebhard, Cathérine
AU  - Fuchs, Tobias A.
AU  - Pazhenkottil, Aju P.
AU  - Nkoulou, Rene N.
AU  - Herzog, Bernhard A.
AU  - Wyss, Christophe A.
AU  - Gaemperli, Oliver
AU  - Kaufmann, Philipp A.
TI  - Diagnostic Value of <sup>13</sup>N-Ammonia Myocardial Perfusion PET: Added Value of Myocardial Flow Reserve
AID  - 10.2967/jnumed.111.101840
DP  - 2012 Aug 01
TA  - Journal of Nuclear Medicine
PG  - 1230--1234
VI  - 53
IP  - 8
4099  - http://jnm.snmjournals.org/content/53/8/1230.short
4100  - http://jnm.snmjournals.org/content/53/8/1230.full
SO  - J Nucl Med2012 Aug 01; 53
AB  - The ability to obtain quantitative values of flow and myocardial flow reserve (MFR) has been perceived as an important advantage of PET over conventional nuclear myocardial perfusion imaging (MPI). We evaluated the added diagnostic value of MFR over MPI alone as assessed with 13N-ammonia and PET/CT to predict angiographic coronary artery disease (CAD). Methods: Seventy-three patients underwent 1-d adenosine stress–rest 13N-ammonia PET/CT MPI, and MFR was calculated. The added value of MFR as an adjunct to MPI for predicting CAD (luminal narrowing ≥ 50%) was evaluated using invasive coronary angiography as a standard of reference. Results: Per patient, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of MPI for detecting significant CAD were 79%, 80%, 91%, 59%, and 79%, respectively. Adding a cutoff of less than 2.0 for global MFR to MPI findings improved the values to 96% (P < 0.005), 80%, 93%, 89% (P < 0.005), and 92% (P < 0.005), respectively. Conclusion: The quantification of MFR in 13N-ammonia PET/CT MPI provides a substantial added diagnostic value for detection of CAD. Particularly in patients with normal MPI results, quantification of MFR helps to unmask clinically significant CAD.