Hybrid CT angiography and quantitative O-15-water PET for assessment of coronary artery disease: comparison with quantitative coronary angiography

作者：Thomassen Anders^*; Petersen Henrik; Diederichsen Axel C P; Mickley Hans; Jensen Lisette O; Johansen Allan; Gerke Oke; Braad Poul Erik; Thayssen Per; Hoilund Carlsen Mette M; Vach Werner; Knuuti Juhani; Hoilund Carlsen Poul F

来源：European Journal of Nuclear Medicine and Molecular Imaging, 2013, 40(12): 1894-1904.

DOI：10.1007/s00259-013-2519-3

• Myocardial blood flow
• Hybrid imaging
• PET/CT
• Quantification
• O-15-Water

Purpose CT angiography (CTA) can rule out significant stenoses with a very high reliability, whereas its ability to confirm significant stenoses is suboptimal. In contrast, measurements of myocardial blood flow (MBF) provide information on the haemodynamic consequences of stenoses. Therefore, a combination of the two might improve diagnostic accuracy. We conducted a head-to-head comparison of CTA, measurement of MBF by O-15-water PET, and hybrid PET/CTA for the detection of significant coronary artery stenoses. %26lt;br%26gt;Methods The study group comprised 44 outpatients scheduled for invasive coronary angiography (ICA) with an intermediate pretest likelihood of coronary artery disease. The patients underwent 64-slice CTA and baseline and hyperaemic PET before ICA with quantitative coronary angiography analysis. %26lt;br%26gt;Results On a per-patient basis, the negative predictive values (NPV; 95 % confidence intervals in parentheses) were 88 % (64 - 97 %) for CTA, 90 % (71 - 97%) for PET and 92 % (74 - 98%) for PET/CTA, and the positive predictive values (PPV) were 71 % (53 - 85%) for CTA, 87 % (68 - 95%) for PET and 100 % (84 - 100%) for PET/CTA. Similarly, on a per-vessel basis the NPVs (which were generally high) were 97 % (94 - 100%) for CTA, 95 % (90 - 99%) for PET and 97 % (95 - 100%) for PET/CTA, and the PPVs (which were lower, but higher with PET/CTA) were 53 % (39 - 66%) for CTA, 53 % (40 - 66%) for PET and 85 % (73 - 97%) for PET/CTA. In six patients, CTA analysis was hampered by the presence of severe calcifications. However, with the addition of the PET data, all six patients were correctly categorized. %26lt;br%26gt;Conclusion Cardiac quantitative hybrid PET/CTA imaging has better diagnostic accuracy than CTA alone and PET alone. CTA has a suboptimal PPV, suggesting that hybrid PET/CTA imaging should be used to assess the significance of coronary stenoses diagnosed by CTA.

• 出版日期2013-12
• 单位河北医科大学