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.
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.
['Hyafil|Fabien|F|', 'Chequer|Renata|R|', 'Sorbets|Emmanuel|E|', 'Estellat|Candice|C|', 'Ducrocq|Gregory|G|', 'Rouzet|François|F|', 'Alfaiate|Toni|T|', 'Regaieg|Hamza|H|', 'Abtan|Jérémie|J|', 'Leygnac|Sébastien|S|', 'Milliner|Milan|M|', 'Imbert|Laetitia|L|', 'Burg|Samuel|S|', 'Ben Azzouna|Rana|R|', 'Potier|Louis|L|', 'Laouénan|Cédric|C|', 'Quintin|Caroline|C|', 'Roussel|Ronan|R|', 'Hartemann|Agnès|A|', 'Montalescot|Gilles|G|', 'Marie|Pierre-Yves|PY|', 'Steg|Gabriel|G|', 'Le Guludec|Dominique|D|']
D000368:Aged D019540:Area Under Curve D015992:Body Mass Index D002104:Cadmium D003324:Coronary Artery Disease D005260:Female D006801:Humans D007091:Image Processing, Computer-Assisted D008297:Male D008875:Middle Aged D017202:Myocardial Ischemia D050177:Overweight D049268:Positron-Emission Tomography D015203:Reproducibility of Results D012307:Risk Factors D012413:Rubidium D012680:Sensitivity and Specificity D013691:Tellurium D015899:Tomography, Emission-Computed, Single-Photon D015032:Zinc
SPECT CZT camera 82-Rubidium CAD Diagnostic and prognostic application MPI Myocardial blood flow PET