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Novel agent improves myocardial perfusion imaging in patients with obesity

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CHICAGO — A novel PET agent for myocardial perfusion imaging had better sensitivity than and similar specificity to myocardial perfusion imaging with single-photon emission CT in patients with obesity, according to recent study findings.

According to the study background, noninvasive imaging for CAD can be difficult in patients with obesity (BMI 30 kg/m²), often resulting in poor image quality.

Researchers are assessing the performance of the novel agent (flurpiridaz F 18, Lantheus Medical Imaging) in a phase 3 study compared with SPECT. At the American College of Cardiology Scientific Session, they reported a secondary endpoint, accuracy in patients with obesity compared with SPECT.

Timothy M. Bateman, MD, from Mid-America Heart Institute, Kansas City, Missouri, and colleagues reported that of the 795 patients in the overall study, 55% were obese (mean age, 61 years; mean BMI, 35 kg/m²).

The novel agent was safe and well-tolerated and was associated with reduced radiation exposure compared with SPECT (mean effective dose for PET, 6.1 mSv; mean effective dose for SPECT, 13.2 mSv; P < .001), according to the researchers.

Bateman and colleagues found that PET with the novel agent was superior in sensitivity (71.1% vs. 51.7%; P < .001) and noninferior in specificity (PET, 79.8%; SPECT, 77.5%; P for noninferiority = .002) compared with SPECT for detection of CAD (stenosis 50% in at least one major coronary artery) in patients with obesity.

They also found that PET with the novel agent showed superior diagnostic accuracy (P < .001), diagnostic confidence (P = .002), image quality at rest (P < .001) and image quality under stress (P < .001) compared with SPECT.

When the researchers analyzed the area under the receiver operating characteristic curve, they determined that PET with the novel agent was superior to SPECT in diagnosing CAD in this population (PET, 0.7887; SPECT, 0.6946; P < .001).

“Nearly 70% of American adults are either overweight or obese, putting this patient population at a greater risk of heart disease, stroke, diabetes and other potential health problems,” Bateman said in a press release. “Obese patients present a significant imaging challenge, and improved imaging modalities are needed to accurately and reliably assess this patient population. The results of this study provide evidence of the particular utility and future potential of flurpiridaz F 18 PET imaging for the diagnosis of [CAD] in people with a BMI of 30 or higher.” – by Erik Swain

Reference:

Bateman TM, et al. Poster 1279M-01. Presented at: American College of Cardiology Scientific Session; April 2-4, 2016; Chicago.

Disclosure: Bateman reports consulting for JubilantDraxImage and Lantheus Medical Imaging, having an ownership interest in CVIT and receiving research grants from Astellas.