• Diagnostic Accuracy of Rubidium-82 Myocardial

Perfusion Imaging using PET CT

• Diagnostic Accuracy of Rubidium-82 Myocardial

Perfusion Imaging using PET CT

Normal Rubidium-82 Myocardial Perfusion PET-CT Study

Abnormal Rubidium-82 Myocardial Perfusion PET-CT Study

Limitations

Limitations• May underestimate the anatomical extent of

CAD in some patients with multivessel disease.

• Subclinical vessel disease may have normal perfusion studies.

• Not all patients with normal perfusion study get CTA or Cath. Adds bias to the true Negative group

• May underestimate the anatomical extent of CAD in some patients with multivessel disease.

• Subclinical vessel disease may have normal perfusion studies.

• Not all patients with normal perfusion study get CTA or Cath. Adds bias to the true Negative group

Advantage of ECG-gated PET

• Assess LV function at rest and during peak stress

• Healthy pts: LVEF increases during peak vasodilator stress

• Patients with left main or 3 vessel CAD show decrease in LVEF at peak stress even in the absence of perfusion abnormalities

Sensitivity

• 93% in single vessel disease.• 92% in multivessel disease.

• May have a slight bias as many normals don’t have correlative coronary angiography.

• MDCT angiography shows high degree of correlation with Rubidium-82 Myocardial Perfusion PET-CT.

Integrated PET/CTA study

Integrated PET/CTA study:

• Noncalcified plaque (arrow) in proximal LAD with 50%–70% stenosis. However, rest and peak stress myocardial perfusion PET study (bottom left panel) demonstrates only minimal inferoapical ischemia.

Conclusion

• Myocardial perfusion PET-CT :• high sensitivity for detection of CAD. • applicable to both men and women,

nonobese and obese patients.• Patients with single-vessel as well as

multivessel coronary disease. • Rest and stress imaging is completed in

approximately 25 min.

• Myocardial perfusion PET-CT :• high sensitivity for detection of CAD. • applicable to both men and women,

nonobese and obese patients.• Patients with single-vessel as well as

multivessel coronary disease. • Rest and stress imaging is completed in

approximately 25 min.

Fast