Rb-82心肌灌注PET和基于Tc-99m的SPECT在极度肥胖患者中的临床性能。
Clinical performance of Rb-82 myocardial perfusion PET and Tc-99m-based SPECT in patients with extreme obesity.
作者信息
Harnett David T, Hazra Samir, Maze Ronnen, Mc Ardle Brian A, Alenazy Ali, Simard Trevor, Henry Ellen, Dwivedi Girish, Glover Christopher, deKemp Robert A, Davies Ross A, Ruddy Terrence D, Chow Benjamin J W, Beanlands Rob S, Hibbert Benjamin
机构信息
Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
CAPITAL Research Group, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada.
出版信息
J Nucl Cardiol. 2019 Feb;26(1):275-283. doi: 10.1007/s12350-017-0855-6. Epub 2017 Mar 29.
BACKGROUND
We evaluated the performance of stress imaging with technetium-99m-labeled tetrofosmin single-photon emission computed tomography (SPECT) and rubidium-82 positron emission tomography (PET) in patients with extreme obesity, defined as body mass index ≥40 kg/m.
METHODS
We identified patients with extreme obesity who underwent angiography in our center and either stress SPECT or PET within the previous six months. Cohorts of patients with extreme obesity and a <5% pretest likelihood of CAD who underwent SPECT (N = 25) or PET (N = 25) were also included.
RESULTS
In total, 108 patients who underwent SPECT (N = 57) or PET (N = 51) were identified. Scan interpretation was classified as definitely normal or abnormal in 83.3% of PET and 60.5% of SPECT scans, respectively (P < .01). PET demonstrated higher diagnostic accuracy and normalcy rate. PET was found to have higher specificity for the pooled cohort. Similar findings were observed using stenosis cut-offs of ≥50% and ≥70%.
CONCLUSIONS
In patients with extreme obesity, PET enabled more definitive scan interpretation with less artifact compared to SPECT. PET provided higher diagnostic accuracy and specificity in the detection of obstructive coronary artery disease.
背景
我们评估了用锝-99m标记的替曲膦单光子发射计算机断层扫描（SPECT）和铷-82正电子发射断层扫描（PET）对极度肥胖患者（定义为体重指数≥40kg/m²）进行应激成像的性能。
方法
我们确定了在我们中心接受血管造影且在过去六个月内接受过应激SPECT或PET检查的极度肥胖患者。还纳入了接受SPECT（N = 25）或PET（N = 25）检查、CAD预测试概率<5%的极度肥胖患者队列。
结果
总共确定了108例接受SPECT（N = 57）或PET（N = 51）检查的患者。PET扫描和SPECT扫描分别有83.3%和60.5%的扫描解读被分类为明确正常或异常（P <.01）。PET显示出更高的诊断准确性和正常率。发现PET对合并队列具有更高的特异性。使用≥50%和≥70%的狭窄截断值时观察到类似结果。
结论
在极度肥胖患者中，与SPECT相比，PET能够在伪影较少的情况下进行更明确的扫描解读。PET在检测阻塞性冠状动脉疾病方面提供了更高的诊断准确性和特异性。
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