Department of Radiology, Emory University School of Medicine, 1364 Clifton Road, NE, Atlanta, GA 30322, USA.
J Nucl Cardiol. 2010 Apr;17(2):247-53. doi: 10.1007/s12350-009-9170-1. Epub 2009 Nov 24.
To compare the diagnostic accuracy of Rb-82 myocardial perfusion three-dimensional (3D) PET with and without prompt-gamma compensation (PGC).
Retrospective, single center study of 76 patients who had rest and adenosine stress Rb-82 myocardial perfusion 3D PET. All studies were acquired using a Siemens Biograph-40 PET/CT scanner and were reconstructed with and without PGC. Fifty-seven patients (mean age 63 +/- 11 years, 26 men) had coronary angiography within 40 days of Rb-82 imaging. Nineteen patients (mean age 43 +/- 7 years, 10 men) had low likelihood of coronary artery disease (CAD). All PET images were scored by consensus of two blinded readers on a standard 5-point scale using a 17-segment left ventricular model. A normal PET test was defined as a summed stress score of less than four. Obstructive CAD at coronary angiography was used as the gold-standard and was defined as luminal stenoses > or =50% in one or more major coronary arteries. The prevalence of obstructive disease at coronary angiography was 68% (39/57). The mean summed stress score was 12 +/- 12 for PGC images and was 18 +/- 14 for non-PGC images. Sensitivity and specificity for obstructive CAD were 90% (95% CI 88-99) and 72% (95% CI 52-93) for PGC images and 95% (95% CI 88-100) and 22% (95% CI 3-41) for non-PGC images.
PGC in Rb-82 3D PET improves the specificity for obstructive CAD at coronary angiography with no significant loss in sensitivity.
比较铷-82 心肌灌注三维（3D）正电子发射断层扫描（PET）有无即刻伽马补偿（PGC）时的诊断准确性。
对 76 例行静息和腺苷负荷铷-82 心肌灌注 3D PET 的患者进行回顾性、单中心研究。所有研究均使用西门子 Biograph-40 PET/CT 扫描仪采集，并分别进行有和无 PGC 的重建。57 例患者（平均年龄 63 +/- 11 岁，26 例男性）在铷-82 成像后 40 天内行冠状动脉造影。19 例患者（平均年龄 43 +/- 7 岁，10 例男性）患冠状动脉疾病（CAD）的可能性较低。所有 PET 图像均由两位盲法阅片者采用 17 节段左心室模型进行共识评分，评分标准为 5 分制。正常 PET 试验定义为总和应激评分小于 4 分。冠状动脉造影中发现的阻塞性 CAD 作为金标准，定义为一个或多个主要冠状动脉的管腔狭窄大于等于 50%。冠状动脉造影中阻塞性疾病的患病率为 68%（39/57）。PGC 图像的平均总和应激评分为 12 +/- 12，而非 PGC 图像的平均总和应激评分则为 18 +/- 14。PGC 图像对阻塞性 CAD 的敏感性和特异性分别为 90%（95%CI 88-99）和 72%（95%CI 52-93），而非 PGC 图像的敏感性和特异性分别为 95%（95%CI 88-100）和 22%（95%CI 3-41）。
铷-82 3D PET 中的 PGC 可提高冠状动脉造影中阻塞性 CAD 的特异性，而不会显著降低敏感性。
