scholarly journals Quantitative Assessment of Regional Myocardial Flow Reserve Using Tc-99m-Sestamibi Imaging

2005 ◽  
Vol 69 (2) ◽  
pp. 188-193 ◽  
Author(s):  
Takahiro Tsukamoto ◽  
Yoshinori Ito ◽  
Kazuyuki Noriyasu ◽  
Koichi Morita ◽  
Chietsugu Katoh ◽  
...  
2021 ◽  
Author(s):  
Matthieu DIETZ ◽  
Christel H Kamani ◽  
Gilles Allenbach ◽  
Vladimir Rubimbura ◽  
Stephane Fournier ◽  
...  

Abstract Purpose The aim of this study was to assess the most reliable quantitative variable on Rubidium-82 (82Rb) cardiac PET/CT for predicting major adverse cardiovascular events (MACE), on the latest PET camera using silicon photomultipliers digital readout (SiPM) technology. Methods We prospectively enrolled 274 consecutive participants with suspected myocardial ischemia. Participants underwent 82Rb cardiac SiPM PET/CT and were followed-up for MACE over 652 days (interquartile range: 559 to 751 days). For each participant, global and regional myocardial flow reserve (MFR), stress myocardial blood flow (stress MBF) and their combination as myocardial flow capacity radius (MFC radius) were measured. Results On receiver operator curve analysis, MACE prediction was similar for global and regional MFR, stress MBF, and MFC radius (area under the curve; (i) Global: 0.70 vs. 0.71 and 0.73, and (ii) Regional: 0.71 vs. 0.71 and 0.73, respectively, p > 0.1 for all pairwise comparisons). On multivariable analysis, (i) Global: MFR < 1.98, stress MBF < 1.94 mL/g/min, and MFC radius < 3.12, as well as (ii) Regional: MFR < 1.75, stress MBF < 1.75 mL/g/min, and MFC radius < 2.7, emerged all as similar independent predictors of MACE (p < 0.001 for all). Conclusions Using the latest SiPM PET technology with 82Rb, global and regional MFR, stress MBF, and MFC radius are similar powerful predictors of cardiovascular event.


2021 ◽  
pp. jrheum.210040
Author(s):  
Attila Feher ◽  
Nabil E. Boutagy ◽  
Evangelos K. Oikonomou ◽  
Stephanie Thorn ◽  
Yi-Hwa Liu ◽  
...  

Objective To investigate the association between Raynaud phenomenon (RP) and coronary microvascular dysfunction, we measured myocardial flow reserve (MFR) using positron emission tomography/computed tomography (PET/CT) in primary and secondary RP patients and controls. Methods RP patients, patient controls and healthy participants who underwent dynamic reststress 82-Rubidium PET/CT were studied. Differences in heart rate-blood pressure product corrected MFR and clinical predictors of reduced MFR (< 2.0) were determined. Results 49 RP patients (80% female, 65 ± 11 years): 11 primary RP, 18 systemic sclerosis (SSc) and 20 other autoimmune diseases (AID) (n=6 systemic lupus erythematosus, n=6 rheumatoid arthritis, n=4 overlap syndrome, n=2 Sjogren's syndrome, n=2 inflammatory arthritis), 49 matched patients without RP or AID (78% female, 64 ± 13 years) and 14 healthy participants (50% female, 35 ± 5 years) were studied. Primary RP patients, matched patient controls and healthy participants had comparable MFR. SSc-RP patients had significantly reduced MFR (1.62 ± 0.32) compared to matched patient controls (p=0.03, 2.06 ± 0.61) and to healthy participants (p=0.01, 2.22 ± 0.44). In multivariable logistic regression, SSc was an independent predictor of reduced MFR. We identified a correlation between time since AID diagnosis and MFR (r= -0.37; 95% CI: -0.61 to -0.09; p=0.01). Conclusion Our findings suggest that only secondary, not primary, RP is associated with reduced MFR, and that SSc-RP patients have reduced MFR compared to primary RP and other


Author(s):  
Yuka Matsuo ◽  
Michinobu Nagao ◽  
Atsushi Yamamoto ◽  
Kiyoe Ando ◽  
Risako Nakao ◽  
...  

Objectives: Resting coronary flow index (rCFI) estimated by 320-detector low-dose dynamic coronary CT angiography (CCTA) is a direct flow quantification using intracoronary attenuation. We propose modified-rCFI from new protocol combining dynamic scan and standard CCTA using dose-modulation, and validate its consistency with quantitative values and ischemia depicted by 13N-ammonia PET (NH3-PET). Methods: 46 patients who underwent dynamic CCTA and NH3-PET for coronary artery disease were evaluated using original rCFI in 21 patients and modified-rCFI in 25 patients. Two types of rCFI were calculated for three major coronary arteries. Myocardial blood flow (MBF) at rest and stress, myocardial flow reserve (MFR), and the presence or absence of ischemia for three major territories were depicted by NH3-PET. Coronary territories were categorized as territories with MFR <2.0, ≥2.0, or with and without ischemia. Receiver operating characteristic analysis was performed to determine the optimal cut-off of rCFI to distinguish territories with MFR <2.0 or the presence of ischemia. Results: rCFI and modified-rCFI had significant positive correlations with stress MBF and MFR. The optical cut-offs of rCFI and modified-rCFI of 0.39 and 0.61 could detect territories with MFR <2.0, with AUCs of 0.75 and 0.73, sensitivities of 48 and 34%, and specificities of 97 and 98%. Optimal cut-offs of rCFI and modified-rCFI distinguished ischemic segments from non-ischemic segments, with AUCs of 0.75 and 0.91, sensitivities of 53 and 50%, and specificities of 93 and 95%. Conclusion: Two types of rCFI correlated with quantitative values from NH3-PET, and were consistent with a high specificity in detecting functional ischemia. Advances in knowledge: rCFI can contribute as additional functional test over standard CCTA in clinical work-up.


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