TY - JOUR

T1 - 82Rb and [15O]H2O myocardial perfusion PET imaging

T2 - a prospective head to head comparison

AU - Krakauer, Martin

AU - Ismail, Afefah

AU - Talleruphuus, Ulrik

AU - Henriksen, Alexander Cuculiza

AU - Lonsdale, Markus N.

AU - Rasmussen, Inge Lise

AU - Fuglsang, Stefan

AU - Prescott, Eva

AU - Hovind, Peter

AU - Marner, Lisbeth

N1 - Publisher Copyright: © 2023, The Author(s).

PY - 2023

Y1 - 2023

N2 - Background: 82Rb PET and [15O]H2O PET are both validated tracers for myocardical perfusion imaging but have not previously been compared clinically. During our site’s transition from 82Rb to [15O]H2O PET, we performed a head-to-head comparison in a mixed population with suspected ischemic heart disease. Methods: A total of 37 patients referred for perfusion imaging due to suspicion of coronary stenosis were examined with both 82Rb and [15O]H2O PET on the same day in rest and during adenosine-induced stress. The exams were rated by two blinded readers as normal, regional ischemia, globally reduced myocardial perfusion, or myocardial scarring. For [15O]H2O PET, regional ischemia was defined as two neighboring segments with average stress perfusion ≤ 2.3 mL/(min·g). Further, we evaluated a total perfusion deficit (TPD) of ≥ 10% as a more conservative marker of ischemia. Results: [15O]H2O PET identified more patients with regional ischemia: 17(46%) vs 9(24%), agreement: 59% corresponding to a Cohen’s kappa of.31 [95%CI.08-.53], (P < .001). Using the more conservative TPD ≥ 10%, the agreement increased to 86% corresponding to a kappa of.62 [95%CI.33-.92], (P = .001). For the subgroup of patients with no known heart disease (n = 18), the agreement was 94%. Interrater agreement was 95% corresponding to a kappa of.89 [95%CI.74-1.00] (P < .001). Conclusions: In clinical transition from 82Rb to [15O]H2O PET, it is important to take into account the higher frequency of patients with regional ischemia detected by [15O]H2O PET. Graphical Abstract: [Figure not available: see fulltext.].

AB - Background: 82Rb PET and [15O]H2O PET are both validated tracers for myocardical perfusion imaging but have not previously been compared clinically. During our site’s transition from 82Rb to [15O]H2O PET, we performed a head-to-head comparison in a mixed population with suspected ischemic heart disease. Methods: A total of 37 patients referred for perfusion imaging due to suspicion of coronary stenosis were examined with both 82Rb and [15O]H2O PET on the same day in rest and during adenosine-induced stress. The exams were rated by two blinded readers as normal, regional ischemia, globally reduced myocardial perfusion, or myocardial scarring. For [15O]H2O PET, regional ischemia was defined as two neighboring segments with average stress perfusion ≤ 2.3 mL/(min·g). Further, we evaluated a total perfusion deficit (TPD) of ≥ 10% as a more conservative marker of ischemia. Results: [15O]H2O PET identified more patients with regional ischemia: 17(46%) vs 9(24%), agreement: 59% corresponding to a Cohen’s kappa of.31 [95%CI.08-.53], (P < .001). Using the more conservative TPD ≥ 10%, the agreement increased to 86% corresponding to a kappa of.62 [95%CI.33-.92], (P = .001). For the subgroup of patients with no known heart disease (n = 18), the agreement was 94%. Interrater agreement was 95% corresponding to a kappa of.89 [95%CI.74-1.00] (P < .001). Conclusions: In clinical transition from 82Rb to [15O]H2O PET, it is important to take into account the higher frequency of patients with regional ischemia detected by [15O]H2O PET. Graphical Abstract: [Figure not available: see fulltext.].

KW - Cardiac imaging

KW - extraction fraction

KW - myocardial blood flow

KW - myocardial perfusion, HO

KW - positron emission tomography

KW - radiowater

U2 - 10.1007/s12350-023-03372-7

DO - 10.1007/s12350-023-03372-7

M3 - Journal article

C2 - 37789106

AN - SCOPUS:85173076488

VL - 30

SP - 2790

EP - 2802

JO - Journal of Nuclear Cardiology

JF - Journal of Nuclear Cardiology

SN - 1071-3581

IS - 6

ER -