Division of Nuclear Medicine, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Eur J Nucl Med Mol Imaging. 2012 Aug;39(8):1233-9. doi: 10.1007/s00259-012-2140-x. Epub 2012 May 31.
We compared the quality, interpretive confidence and interreader agreement between SPECT and PET myocardial perfusion imaging (MPI) in the same group of patients.
The study group comprised 27 patients (age 55 ± 8.5 years, 12 men) with known or suspected coronary artery disease (CAD) who had undergone gated rest/stress MPI with (99m)Tc-labelled agent SPECT (with and without attenuation correction, AC), and subsequent clinical confirmation with (82)Rb PET. Three experienced readers blinded to the clinical information interpreted all MPI studies.
Interreader agreement was significantly superior for PET studies than for SPECT studies. Following consensus interpretation, the quality of 22 % of the non-AC SPECT studies, 33 % of the AC SPECT studies and 63 % of the PET studies was assessed as excellent or good (p = 0.016). Interpretations were definitely normal or abnormal in 7 % of non-AC SPECT studies, 30 % of AC SPECT studies and 85 % of PET studies (p = 0.046). In 13 patients who had received either invasive coronary angiography or CT angiography with no significant CAD, the true-positive rate for significant CAD was higher for PET, and the true-negative rate was equal for PET and AC SPECT, and lower for non-AC SPECT.
(82)Rb PET MPI, used as a confirmatory test after SPECT, offers improved image quality, interpretive confidence and interreader agreement.
我们比较了同组患者中 SPECT 和 PET 心肌灌注成像（MPI）的质量、解释信心和读者间一致性。
研究组包括 27 名年龄为 55±8.5 岁的已知或疑似冠心病（CAD）患者（12 名男性），他们接受了门控静息/应激 MPI 与（99m）Tc 标记药物 SPECT（有和没有衰减校正，AC）检查，并随后进行（82）Rb PET 临床验证。三名经验丰富的读者在不了解临床信息的情况下对所有 MPI 研究进行解读。
读者间一致性在 PET 研究中明显优于 SPECT 研究。在共识解读后，22%的非 AC SPECT 研究、33%的 AC SPECT 研究和 63%的 PET 研究的质量被评估为优秀或良好（p=0.016）。7%的非 AC SPECT 研究、30%的 AC SPECT 研究和 85%的 PET 研究的解读为明确正常或异常（p=0.046）。在 13 名接受过无显著 CAD 的有创冠状动脉造影或 CT 血管造影的患者中，PET 对显著 CAD 的真阳性率更高，PET 和 AC SPECT 的真阴性率相等，而非 AC SPECT 的真阴性率更低。
（82）Rb PET MPI 作为 SPECT 后的确认性检查，提供了更好的图像质量、解释信心和读者间一致性。
