Diagnostic Value of N-13-Ammonia Myocardial Perfusion PET: Added Value of Myocardial Flow Reserve

作者：Fiechter Michael; Ghadri Jelena R; Gebhard Catherine; Fuchs Tobias A; Pazhenkottil Aju P; Nkoulou Rene N; Herzog Bernhard A; Wyss Christophe A; Gaemperli Oliver; Kaufmann Philipp A^*

来源：Journal of Nuclear Medicine, 2012, 53(8): 1230-1234.

DOI：10.2967/jnumed.111.101840

• myocardial flow reserve
• N-13-ammonia
• positron emission tomography
• diagnostic value
• myocardial perfusion imaging

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 N-13-ammonia and PET/CT to predict angiographic coronary artery disease (CAD). Methods: Seventy-three patients underwent 1-d adenosine stress-rest N-13-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 N-13-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.

• 出版日期2012-8