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Stress perfusion/metabolism imaging: A pilot study for a potential new approach to the diagnosis of coronary disease in women

  • Original Articles
  • Published:
Journal of Nuclear Cardiology Aims and scope

Abstract

Background

The diagnosis of coronary artery disease (CAD) in women continues to be a challenge. f-18 deoxyglucose (FDG) positron emission tomography (PET) has been used for detection of myocardial ischemia at rest. Little has been reported about FDG stress imaging. The aim of this pilot study was to assess stress FDG PET imaging for defining CAD in a group of women referred for chest pain.

Methods

Stress FDG imaging was performed in 19 women (mean age 59±10 years). All had abnormal stress testing before entering the study. FDG and 2-methoxy-2-methylpropyl isonitrile were injected at peak stress (treadmill n=8, dipyridam ole n=11) followed by PET and single photon emission computed tomography image acquisitions. Myocardial ischemia was defined by regions that demonstrated both a defect on perfusion imaging and increased FDG uptake relative to uptake in normal perfusion zones. Defect/normal zone FDG ratios were also determined. Coronary angiography was performed on all patients.

Results

Average, or mean, body mass index was high at 29.2±5kg/m2. Nine of 19 patients had significant CAD. Eight of 9 with CAD had FDG-defined ischemia. Nine of the 10 without CAD had negative FDG images (sensitivity 89%., specificity 90%). The average defect/normal zone FDG ratio was greater in patients with CAD than in those without (2.4±1.9 vs 0.9±0.4, P<.05).

Conclusions

Regional FDG uptake in areas of perfusion defects with stress increased in this group with CAD. These pilot data suggest that stress FDG PET may be diagnostically helpful in obese female patients. This novel approach may complement current methods of CAD detection in women and warrants further study.

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Author information

Authors and Affiliations

  1. Division of Cardiology, St Michael's Hospital, 30 Bond St, Rm 3-054, Victoria Wing, M5B 1W8, Toronto, Ontario, Canada

    Beth L. Abramson

  2. Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada

    Terrence D. Ruddy, R. A. deKemp, Louise A. Laramee, J. F. Marquis & Rob S. B. Beanlands

Authors
  1. Beth L. Abramson
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  2. Terrence D. Ruddy
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  3. R. A. deKemp
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  4. Louise A. Laramee
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  5. J. F. Marquis
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  6. Rob S. B. Beanlands
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Corresponding author

Correspondence to Beth L. Abramson.

Additional information

Beth L. Abramson, MD, was a Research Fellow supported by the Heart and Stroke Foundation of Canada, Ottawa, Canada, during this study and was supervised by R.S.B. Beanlands.

Terrence D. Ruddy, MD, was a Research, Scholar supported by the Heart and Stroke Foundation of Canada, Ottawa, Canada, during this study.

Rob S.B. Beanlands, MD, is a Research Scientist supported by the Medical Research Council of Canada, Ottawa, Canada.

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Abramson, B.L., Ruddy, T.D., deKemp, R.A. et al. Stress perfusion/metabolism imaging: A pilot study for a potential new approach to the diagnosis of coronary disease in women. J Nucl Cardiol 7, 205–212 (2000). https://doi.org/10.1016/S1071-3581(00)70008-0

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  • DOI: https://doi.org/10.1016/S1071-3581(00)70008-0

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