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Metabolic PET imaging provided earlier warning of CAD
Exercise F-18 fluorodeoxyglucose PET demonstrated significantly better performance than stress myocardial perfusion imaging for the detection of ischemia in patients with stenosis of more than 50%, according to research presented at the Society of Nuclear Medicine and Molecular Imaging Annual Meeting.
The study compared angiography with two molecular imaging modalities — exercise stress myocardial perfusion imaging (MPI) with technetium-99m tetrofosmin vs. exercise stress F-18 fluorodeoxyglucose (FDG) PET imaging — to determine performance in the detection of ischemia in CAD. Researchers enrolled 45 patients (mean age, 51 years; 37 men) with suspected CAD and no history of MI. All of the patients were prescribed dietary restriction and underwent exercise stress tests on separate days followed by a coronary angiogram within 1 month, according to a press release.
Angiography was performed as a baseline imaging protocol for comparison between MPI and FDG PET. Twenty-seven patients had an abnormal angiogram (at least one coronary artery with stenosis >50%). Of those patients, 17 had single-vessel disease, five had double-vessel disease and five had triple-vessel disease.
Results comparing MPI vs. FDG PET revealed similar disease detection in patients with multivessel disease, but superiority of FDG PET in single-vessel disease (P=.0005). Performance of both modalities was comparable in the right coronary artery territory, but FDG PET demonstrated better performance than MPI in the left anterior descending and left circumflex coronary artery territories. The researchers reported equal performance of both modalities in patients with >70% stenosis (P=.61). In those patients with >50% stenosis, sensitivity was 96% for FDG PET vs. 56% for MPI and the overall accuracy was 76% for FDG PET vs. 62% for MPI (P=.0004), according to data in the abstract.
The researchers concluded that FDG PET may be “a better imaging modality for detecting ischemia in patients with stenosis between 50% to 70%.”
“This research is extremely important because it opens up the possibility of using nuclear imaging in preventive cardiology,” Arun Sasikumar, MD, MBBS, of the department of nuclear medicine and PET at the Postgraduate Institute of Medical Education and Research in Chandigarh, India, said in the press release. “FDG PET imaging can detect ischemia at a very early stage, even before significant symptoms appear. This molecular imaging technique could potentially be used for initial CAD screening to help doctors better determine a patient’s cardiac risk and manage the care of these patients, who would otherwise be considered to have normal CV function.
For more information:
Sasikumar A. Scientific paper #349. Presented at: the Society of Nuclear Medicine and Molecular Imaging 60th Annual Meeting; June 8-12, 2013; Vancouver, British Columbia.
Disclosure: The researchers report no relevant financial disclosures.
Exercise F-18 fluorodeoxyglucose PET demonstrated significantly better performance than stress myocardial perfusion imaging for the detection of ischemia in patients with stenosis of more than 50%, according to research presented at the Society of Nuclear Medicine and Molecular Imaging Annual Meeting.
The study compared angiography with two molecular imaging modalities — exercise stress myocardial perfusion imaging (MPI) with technetium-99m tetrofosmin vs. exercise stress F-18 fluorodeoxyglucose (FDG) PET imaging — to determine performance in the detection of ischemia in CAD. Researchers enrolled 45 patients (mean age, 51 years; 37 men) with suspected CAD and no history of MI. All of the patients were prescribed dietary restriction and underwent exercise stress tests on separate days followed by a coronary angiogram within 1 month, according to a press release.
Angiography was performed as a baseline imaging protocol for comparison between MPI and FDG PET. Twenty-seven patients had an abnormal angiogram (at least one coronary artery with stenosis >50%). Of those patients, 17 had single-vessel disease, five had double-vessel disease and five had triple-vessel disease.
Results comparing MPI vs. FDG PET revealed similar disease detection in patients with multivessel disease, but superiority of FDG PET in single-vessel disease (P=.0005). Performance of both modalities was comparable in the right coronary artery territory, but FDG PET demonstrated better performance than MPI in the left anterior descending and left circumflex coronary artery territories. The researchers reported equal performance of both modalities in patients with >70% stenosis (P=.61). In those patients with >50% stenosis, sensitivity was 96% for FDG PET vs. 56% for MPI and the overall accuracy was 76% for FDG PET vs. 62% for MPI (P=.0004), according to data in the abstract.
The researchers concluded that FDG PET may be “a better imaging modality for detecting ischemia in patients with stenosis between 50% to 70%.”
“This research is extremely important because it opens up the possibility of using nuclear imaging in preventive cardiology,” Arun Sasikumar, MD, MBBS, of the department of nuclear medicine and PET at the Postgraduate Institute of Medical Education and Research in Chandigarh, India, said in the press release. “FDG PET imaging can detect ischemia at a very early stage, even before significant symptoms appear. This molecular imaging technique could potentially be used for initial CAD screening to help doctors better determine a patient’s cardiac risk and manage the care of these patients, who would otherwise be considered to have normal CV function.
For more information:
Sasikumar A. Scientific paper #349. Presented at: the Society of Nuclear Medicine and Molecular Imaging 60th Annual Meeting; June 8-12, 2013; Vancouver, British Columbia.
Disclosure: The researchers report no relevant financial disclosures.