Key result
13N-ammonia PET-CT myocardial perfusion imaging demonstrated 90% sensitivity, 90% specificity, and 80% overall diagnostic accuracy for detecting obstructive coronary artery disease.
Why the study?
Although 13N-ammonia PET-CT is increasingly used to evaluate known or suspected CAD, information regarding its diagnostic accuracy remains sparse.
Does 13N-ammonia PET-CT MPI accurately detect obstructive coronary artery disease in patients with suspected CAD?
Observational (n=383)
Does 13N-ammonia PET-CT MPI accurately detect obstructive coronary artery disease in patients with suspected CAD?
13N-ammonia PET-CT MPI provides high sensitivity and specificity for the non-invasive detection of obstructive coronary artery disease.
Supports non-invasive CAD detection in suspected cases; hypothesis-generating and requires prospective validation before practice change.
Background: 13N-ammonia positron emission tomography-computed tomography (PET-CT) is being increasingly used as a non-invasive imaging modality for evaluating patients with known or suspected coronary artery disease (CAD), but information about the diagnostic accuracy of PET-MPI is sparse. Objectives: Our objective was to determine the accuracy of 13N-ammonia PET-CT myocardial perfusion imaging (MPI) for detecting CAD. Methods: We retrospectively evaluated 383 patients with suspected CAD who underwent rest-stress 13N- ammonia PET-CT MPI. Invasive coronary angiography (ICA) was performed within 60 days for all patients with abnormal PET-MPI findings and for selected patients with normal PET-MPI findings. Results: The mean age of the patients was 64±11 years, and the mean body mass index was 32±7 kg/m2. Stress perfusion defects were identified in 147 (34%) out of a total of 383 patients. ICA was performed in 213 patients (145 patients with abnormal PET and 68 patients with normal PET). The sensitivity of PET-MPI for detection of obstructive CAD based on ≥50% stenosis was 90%; specificity, 90%; positive predictive value, 96%; negative predictive value, 76%; and diagnostic accuracy, 80%. Conclusions: PET-MPI with 13N-ammonia affords high sensitivity and overall accuracy for detecting CAD. The addition of coronary artery calcium score (CACS) can improve CAD risk stratification.
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Fathala et al. (2019) conducted an observational in suspected coronary artery disease (n=383). 13N-ammonia PET-CT myocardial perfusion imaging vs. Invasive coronary angiography was evaluated on Detection of obstructive CAD based on ≥50% stenosis. 13N-ammonia PET-CT myocardial perfusion imaging demonstrated 90% sensitivity, 90% specificity, and 80% overall diagnostic accuracy for detecting obstructive coronary artery disease.
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