Comparison of Clinical Usefulness between N-13 Ammonia PET/CT and Tc-99m Sestamibi SPECT in Coronary Artery Disease.
- Author:
Eun Jung KONG
1
;
Ihn Ho CHO
;
Kyung Ah CHUN
;
Kyu Chang WON
;
Hyung Woo LEE
;
Jeong Sun PARK
;
Dong Gu SHIN
;
Young Jo KIM
;
Bong Seop SHIM
Author Information
1. Department of Nuclear Medicine, Yeungnam University, College of Medicine, Daegu, Korea. ihcho@med.yu.ac.kr
- Publication Type:Original Article
- Keywords:
N-13 ammonia;
PET/CT;
SPECT;
myocardial perfusion;
myocardial ischemia
- MeSH:
Adenosine;
Ammonia;
Coronary Angiography;
Coronary Artery Disease;
Coronary Stenosis;
Coronary Vessels;
Gamma Cameras;
Head;
Humans;
Myocardial Ischemia;
Myocardium;
Perfusion;
Positron-Emission Tomography;
Retention (Psychology);
Sensitivity and Specificity;
Tomography, Emission-Computed, Single-Photon
- From:Nuclear Medicine and Molecular Imaging
2008;42(5):354-361
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: N-13 ammonia uptake and retention in the myocardium is related to perfusion and metabolism. There are several potential advantages of N-13 ammonia positron emission tomography (PET) to detect myocardial ischemia, such as higher spatial resolution, greater counting efficiencies, and robust attenuation correction. But there are few reports comparing Tc-99m myocardial perfusion single photon emission tomography (MPS) and N-13 ammonia PET. We thus compared adenosine stress N-13 ammonia PET/CT and Tc-99m sestamibi MPS in patients with suspected coronary artery stenosis. MATERIALS AND METHODS: Seventeen patients (male 13 : 63+/-11 years old) underwent adenosine stress N-13 ammonia PET/CT (Discovery ST, GE), Tc-99m sestamibi MPS (dual head gamma camera, Hawkeye, GE) and coronary angiography within 1 week. N-13 ammonia PET/CT and Tc-99m sestamibi MPS images were assessed with a 20-segment model by visual interpretation and quantitative analysis using automatic quantitative software (Myovation, GE). RESULTS: Both sensitivities and specificities of detecting an individual coronary artery stenosis were higher for N-13 ammonia PET/CT than Tc-99m sestamibi MPS (PET/CT: 91%/ 89% vs MPS: 65%/ 82%). N-13 ammonia PET/CT showed reversibility in 52% of segments that were considered non-reversibile by Tc-99m sestamibi MPS. In the 110 myocardial segments supplied by the stenotic coronary artery, N-13 ammonia PET/CT showed higher count densities than Tc-99m MPS on rest study (p<0.01), and the difference of count density between the stress and the rest studies was also larger on N-13 ammonia PET/CT. CONCLUSION: Adenosine stress N-13 ammonia PET/CT had higher diagnostic sensitivity and specificity, more reversibility of perfusion defects and greater stress/rest uptake differences than Tc-99m sestamibi MPS. Accordingly, N-13 ammonia PET/CT might offer better assessment of myocardial ischemia and viability.
