Groves Ashley M, Speechly-Dick Marie-Elsya, Dickson John C, Kayani Irfan, Endozo Raymondo, Blanchard Patty, Shastry Manu, Prvulovich Elizabeth, Waddington Wendy A, Ben-Haim Simona, Bomanji Jamshed B, McEwan Jean R, Ell Peter J
Institute of Nuclear Medicine, University College London, T-5 235 Euston Road, London, UK.
Eur J Nucl Med Mol Imaging. 2007 Dec;34(12):1965-72. doi: 10.1007/s00259-007-0537-8. Epub 2007 Aug 31.
Myocardial perfusion with PET/CT has advantages over conventional SPECT. We describe our initial European experience using (82)Rubidium-PET/CT, as part of a clinical myocardial perfusion service.
We studied the first 100 patients (64 male; 36 female, mean age = 60: SD +/-12.5y, mean body mass index = 30: SD +/-6.9kg/m( 2 )) who underwent (82)Rubidium cardiac PET/CT in our institution. Thirty patients had recently undergone coronary angiography. Patients underwent imaging during adenosine infusion and at rest. Images were acquired over 5 minutes using a GE-PET/CT instrument. Image quality was described as good, adequate or inadequate. Images were reported patient-by-patient by a minimum of five nuclear medicine physicians. A segment-by-segment analysis (17-segment model) was also performed.
Image quality was good in 77%, adequate 23% and inadequate 0%. There was no statistical difference in image quality between obese and non-obese patients (Fisher's exact test, p = 0.2864). 59% had normal perfusion studies, 29% had inducible ischaemia, 12% had myocardial infarction (11% with super added ischaemia). There was reduced (82)Rubidium uptake in 132/1700 segments during stress. There was reduced (82)Rubidium uptake at rest in 42/1700 segments. The (82)Rubidium PET/CT findings were consistent with the angiographic findings in 28/30 cases.
We show that, even from initial use of (82)Rubidium, it is possible to perform myocardial perfusion studies quickly with good image quality, even in the obese. The PET findings correlated well in the third of the cases where angiography was available. As such, (82)Rubidium cardiac PET/CT is likely to be an exciting addition to the European nuclear physician/ cardiologist's radionuclide imaging arsenal.
正电子发射断层扫描/计算机断层扫描(PET/CT)心肌灌注成像较传统单光子发射计算机断层扫描(SPECT)具有优势。我们描述了作为临床心肌灌注服务的一部分,在欧洲首次使用(82)铷-PET/CT的经验。
我们研究了在本机构接受(82)铷心脏PET/CT检查的前100例患者(64例男性;36例女性,平均年龄 = 60岁:标准差±12.5岁,平均体重指数 = 30:标准差±6.9kg/m²)。30例患者近期接受了冠状动脉造影。患者在静脉输注腺苷期间及静息状态下进行成像。使用GE-PET/CT仪器在5分钟内采集图像。图像质量分为良好、尚可或不佳。至少由五名核医学医师逐例报告图像。还进行了逐节段分析(17节段模型)。
图像质量良好的占77%,尚可的占23%,不佳的占0%。肥胖患者与非肥胖患者的图像质量无统计学差异(Fisher精确检验,p = 0.2864)。59%的患者灌注研究正常,29%的患者有诱发性心肌缺血,12%的患者有心肌梗死(11%合并额外的心肌缺血)。负荷状态下1700个节段中有132个节段(82)铷摄取减少。静息状态下1700个节段中有42个节段(82)铷摄取减少。在30例病例中的28例,(82)铷PET/CT检查结果与血管造影结果一致。
我们表明,即使是首次使用(82)铷,也能够快速进行心肌灌注研究,且图像质量良好,即使对于肥胖患者也是如此。在三分之一可进行血管造影的病例中,PET检查结果与血管造影结果相关性良好。因此,(82)铷心脏PET/CT可能会成为欧洲核医学医师/心脏病专家放射性核素成像武器库中令人兴奋的补充。