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Head-to-head comparison of the diagnostic performances of Rubidium-PET and SPECT with CZT camera for the detection of myocardial ischemia in a population of women and overweight individuals

  • Fabien HyafilEmail author
  • Renata Chequer
  • Emmanuel Sorbets
  • Candice Estellat
  • Gregory Ducrocq
  • François Rouzet
  • Toni Alfaiate
  • Hamza Regaieg
  • Jérémie Abtan
  • Sébastien Leygnac
  • Milan Milliner
  • Laetitia Imbert
  • Samuel Burg
  • Rana Ben Azzouna
  • Louis Potier
  • Cédric Laouénan
  • Caroline Quintin
  • Ronan Roussel
  • Agnès Hartemann
  • Gilles Montalescot
  • Pierre-Yves Marie
  • Gabriel Steg
  • Dominique Le Guludec
Original Article

Abstract

Background

The aim of this study was to compare the diagnostic performances for the detection of myocardial ischemia of 82-Rb-PET-MPS and 99m-Tc-SPECT-MPS in overweight individuals and women.

Methods and Results

Men with BMI ≥ 25 and women referred for MPS were considered for inclusion. All individuals underwent 99m-Tc-SPECT-MPS with CZT cameras and 82-Rb-PET-MPS in 3D-mode. Individuals with at least one positive MPS were referred for coronary angiography (CA) with FFR measurements. A criterion for positivity was a composite endpoint including significant stenosis on CA or, in the absence of CA, the occurrence of acute coronary event during the following year. 313 patients (46% women) with mean BMI of 31.8 ± 6.5 were included. Sensitivity for the detection of myocardial ischemia was higher with 82-Rb-PET-MPS compared with 99m-Tc-SPECT-MPS (85% vs. 57%, P < .05); specificity was equally high with both imaging techniques (93% vs. 94%, P > .05). 82-Rb-PET allowed for a more accurate detection of patients with a high-risk coronary artery disease (HR-CAD) than 99m-Tc-SPECT-MPS (AUC = 0.86 vs. 0.75, respectively; P = .04).

Conclusions

In women and overweight individuals, 82-Rb-PET-MPS provides higher sensitivity for the detection of myocardial ischemia than 99m-Tc-SPECT-MPS thanks to a better image quality and an improved detection of HR-CAD.

Keywords

SPECT MPI Diagnostic and prognostic application Myocardial blood flow CAD PET 82-Rubidium CZT camera 

Abbreviation

CA

Coronary angiography

CAD

Coronary artery disease

CZT

Cadmium-Zinc-Telluride

FFR

Fractional flow reserve

MBq

Mega-Becquerel

MPS

Myocardial perfusion scintigraphy

SPECT

Single Photon Emission Computed Tomography

PET

Positron Emission Tomography

82-Rubidium

82-Rb

99m-Tc

99m-Technetium

Notes

Acknowledgments

We wish to thank Souad Bani, Naima Beldjoudi, Lucile Collas, Audrey Pépin, and Sabrina Salhi who supported us in the setup and monitoring of the RUBIS study (from URC Paris Nord Val de Seine, Assistance Publique – Hôpitaux de Paris, DRCI, Paris, France), and patients who agreed to participate in this study.

Disclosures

Fabien Hyafil is consultant for Naogen and Curium, Dominique Le Guludec is consultant for Advanced Accelerator Applications. The authors Renata Chequer, Emmanuel Sorbets, Candice Estellat, Gregory Ducrocq, François Rouzet, Toni Alfaiate, Hamza Regaieg, Jérémie Abtan, Sébastien Leygnac, Milan Milliner, Laetitia Imbert, Samuel Burg, Rana Ben Azzouna, Louis Potier, Cédric Laouénan, Caroline Quintin, Ronan Roussel, Agnès Hartemann, Gilles Montalescot, Pierre-Yves Marie, Gabriel Steg have nothing to disclose in relation to this manuscript.

Supplementary material

12350_2018_1557_MOESM1_ESM.pptx (2.3 mb)
Supplementary material 1 (PPTX 2324 kb)

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Copyright information

© American Society of Nuclear Cardiology 2018

Authors and Affiliations

  • Fabien Hyafil
    • 1
    • 2
    Email author
  • Renata Chequer
    • 1
  • Emmanuel Sorbets
    • 3
  • Candice Estellat
    • 4
    • 5
  • Gregory Ducrocq
    • 2
    • 6
    • 7
  • François Rouzet
    • 1
    • 2
  • Toni Alfaiate
    • 8
  • Hamza Regaieg
    • 1
  • Jérémie Abtan
    • 6
    • 7
  • Sébastien Leygnac
    • 1
    • 2
  • Milan Milliner
    • 1
    • 2
  • Laetitia Imbert
    • 9
  • Samuel Burg
    • 1
    • 2
  • Rana Ben Azzouna
    • 1
    • 2
  • Louis Potier
    • 10
  • Cédric Laouénan
    • 8
  • Caroline Quintin
    • 8
  • Ronan Roussel
    • 10
  • Agnès Hartemann
    • 11
  • Gilles Montalescot
    • 12
  • Pierre-Yves Marie
    • 9
  • Gabriel Steg
    • 2
    • 6
    • 7
  • Dominique Le Guludec
    • 1
    • 2
  1. 1.Department of Nuclear Medicine, Bichat University Hospital, AP-HPUniversity DiderotParisFrance
  2. 2.INSERM, U-1148, DHU FIREUniversity DiderotParisFrance
  3. 3.Department of Cardiology, Avicenne University Hospital, AP-HPUniversity Paris 13BobignyFrance
  4. 4.Département de Biostatistiques, Hôpital Pitié-Salpêtrière, AP-HPSanté Publique et Informatique MédicaleParisFrance
  5. 5.INSERM, CIC-EC 1425, ECEVE UMR 1123ParisFrance
  6. 6.Department of Cardiology, Bichat University HospitalAP-HPParisFrance
  7. 7.French Alliance for Cardiovascular Trials, and F-CRIN NetworkParisFrance
  8. 8.Département d’Epidémiologie, Hôpital Bichat, AP-HPBiostatistique et Recherche CliniqueParisFrance
  9. 9.Department of Nuclear Medicine, Brambois University HospitalLorraine UniversityVandœuvre-Lès-NancyFrance
  10. 10.Department of Diabetology, DHU FIRE, Bichat University Hospital, AP-HPUniversity DiderotParisFrance
  11. 11.Department of Diabetology, Pitié-Salpétriêre University Hospital, AP-HPSorbonne University Paris 6ParisFrance
  12. 12.ACTION Study Group, Department of Cardiology, Pitié-SalpétriêreSorbonne Université-Paris 6ParisFrance

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