Myocardial Perfusion Imaging With Positron Emission Tomography (PET): A Head-to-Head Comparison of 82 Rubidium Versus 15 O-water Tracers Using Invasive Coronary Measurements as Reference
Authors' conclusion
For detection of obstructive CAD by PET myocardial perfusion imaging, 82 Rb versus 15 O-water have similar diagnostic performance.
Study context
- Population
- Consecutive patients referred for computed tomography angiography (CTA) with symptoms suggestive of obstructive coronary artery disease (CAD); those with suspected stenosis on CTA referred for 82 Rb-PET, 15 O-water-PET and invasive coronary angiography (ICA)consecutive patients referred for CTA, 196/270 (73%) patients with suspected stenosis on CTA completed 82 Rb-PET, 15 O-water-PET, and ICA
- Participants
- 1,000 patients
- Comparison
- 82 Rb-PET vs 15 O-water-PET
- Outcome
- Correlation of myocardial blood flow, 82 Rb-PET vs 15 O-water-PET
Methodological detailsconsecutive patients, invasive coronary measurements as reference
- Consecutive patients
- Invasive coronary measurements as reference
Main finding
As reported in the abstract
At rest (correlated strongly)
ρ, 0.62-0.69
During hyperemia (only moderately)
ρ, 0.41-0.59
Further findings
| Outcome | 82 Rb-PET | 15 O-water-PET | P value |
|---|---|---|---|
| Diagnostic accuracy vs ICA FFR ≤0.80, predefined cutoffs69% versus 71% · diagnostic accuracies similar | P = 0.59 | ||
| Sensitivity | 69% [58-78%] | 71% [60-80%] | |
| Specificity | 85% [76-91%] | 77% [68-85%] | |
| Diagnostic accuracy vs ICA FFR ≤0.80, predefined cutoffs85% versus 77% · diagnostic accuracies similar | P = 0.12 |
Correlation of myocardial blood flow reserve by both PET tracers with ICA coronary flow reserve
- Only weak correlations
- ρ, 0.11-0.38
Hemodynamically obstructive CAD (ICA fractional flow reserve ≤0.80)
- Patients with obstructive CAD
- 86/196 (44%)
Anatomically severe CAD (ICA diameter stenoses >70% as reference)
- Patients with anatomically severe CAD
- 48/196 (24%)
- 82 Rb-PET and 15 O-water-PET sensitivities increased to
- >85%
Original publication
Myocardial Perfusion Imaging With PET: A Head-to-Head Comparison of 82 Rubidium Versus 15 O-water Tracers Using Invasive Coronary Measurements as Reference. Circ Cardiovasc Imaging. Published 3 April 2025. doi:10.
Summarised from the published abstract; every number is checked against it