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Quantification of absolute myocardial perfusion in patients with coronary artery disease: comparison between cardiovascular magnetic resonance and positron emission tomography

Morton, Geraint; Chiribiri, Amedeo; Ishida, Masaki; Hussain, Shazia T; Schuster, Andreas; Indermuehle, Andreas; Perera, Divaka; Knuuti, Juhani; Baker, Stacey and Hedström, Erik LU , et al. (2012) In Journal of the American College of Cardiology 60(16). p.55-1546
Abstract

OBJECTIVES: The aim of this study was to compare fully quantitative cardiovascular magnetic resonance (CMR) and positron emission tomography (PET) myocardial perfusion and myocardial perfusion reserve (MPR) measurements in patients with coronary artery disease (CAD).

BACKGROUND: Absolute quantification of myocardial perfusion and MPR with PET have proven diagnostic and prognostic roles in patients with CAD. Quantitative CMR perfusion imaging has been established more recently and has been validated against PET in normal hearts. However, there are no studies comparing fully quantitative CMR against PET perfusion imaging in patients with CAD.

METHODS: Forty-one patients with known or suspected CAD prospectively underwent... (More)

OBJECTIVES: The aim of this study was to compare fully quantitative cardiovascular magnetic resonance (CMR) and positron emission tomography (PET) myocardial perfusion and myocardial perfusion reserve (MPR) measurements in patients with coronary artery disease (CAD).

BACKGROUND: Absolute quantification of myocardial perfusion and MPR with PET have proven diagnostic and prognostic roles in patients with CAD. Quantitative CMR perfusion imaging has been established more recently and has been validated against PET in normal hearts. However, there are no studies comparing fully quantitative CMR against PET perfusion imaging in patients with CAD.

METHODS: Forty-one patients with known or suspected CAD prospectively underwent quantitative (13)N-ammonia PET and CMR perfusion imaging before coronary angiography.

RESULTS: The CMR-derived MPR (MPR(CMR)) correlated well with PET-derived measurements (MPR(PET)) (r = 0.75, p < 0.0001). MPR(CMR) and MPR(PET) for the 2 lowest scoring segments in each coronary territory also correlated strongly (r = 0.79, p < 0.0001). Absolute CMR perfusion values correlated significantly, but weakly, with PET values both at rest (r = 0.32; p = 0.002) and during stress (r = 0.37; p < 0.0001). Area under the receiver-operating characteristic curve for MPR(PET) to detect significant CAD was 0.83 (95% confidence interval: 0.73 to 0.94) and for MPR(CMR) was 0.83 (95% confidence interval: 0.74 to 0.92). An MPR(PET) ≤1.44 predicted significant CAD with 82% sensitivity and 87% specificity, and MPR(CMR) ≤1.45 predicted significant CAD with 82% sensitivity and 81% specificity.

CONCLUSIONS: There is good correlation between MPR(CMR) and MPR(PET.) For the detection of significant CAD, MPR(PET) and MPR(CMR) seem comparable and very accurate. However, absolute perfusion values from PET and CMR are only weakly correlated; therefore, although quantitative CMR is clinically useful, further refinements are still required.

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keywords
Aged, Coronary Artery Disease, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Myocardial Perfusion Imaging, Positron-Emission Tomography, Reproducibility of Results, Clinical Trial, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't
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Journal of the American College of Cardiology
volume
60
issue
16
pages
10 pages
publisher
Elsevier USA
external identifiers
  • scopus:84867404467
ISSN
0735-1097
DOI
10.1016/j.jacc.2012.05.052
language
English
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no
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89883c19-510a-4030-970c-a1869bccf6c3
date added to LUP
2017-02-02 11:34:02
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2017-10-22 05:25:49
@article{89883c19-510a-4030-970c-a1869bccf6c3,
  abstract     = {<p>OBJECTIVES: The aim of this study was to compare fully quantitative cardiovascular magnetic resonance (CMR) and positron emission tomography (PET) myocardial perfusion and myocardial perfusion reserve (MPR) measurements in patients with coronary artery disease (CAD).</p><p>BACKGROUND: Absolute quantification of myocardial perfusion and MPR with PET have proven diagnostic and prognostic roles in patients with CAD. Quantitative CMR perfusion imaging has been established more recently and has been validated against PET in normal hearts. However, there are no studies comparing fully quantitative CMR against PET perfusion imaging in patients with CAD.</p><p>METHODS: Forty-one patients with known or suspected CAD prospectively underwent quantitative (13)N-ammonia PET and CMR perfusion imaging before coronary angiography.</p><p>RESULTS: The CMR-derived MPR (MPR(CMR)) correlated well with PET-derived measurements (MPR(PET)) (r = 0.75, p &lt; 0.0001). MPR(CMR) and MPR(PET) for the 2 lowest scoring segments in each coronary territory also correlated strongly (r = 0.79, p &lt; 0.0001). Absolute CMR perfusion values correlated significantly, but weakly, with PET values both at rest (r = 0.32; p = 0.002) and during stress (r = 0.37; p &lt; 0.0001). Area under the receiver-operating characteristic curve for MPR(PET) to detect significant CAD was 0.83 (95% confidence interval: 0.73 to 0.94) and for MPR(CMR) was 0.83 (95% confidence interval: 0.74 to 0.92). An MPR(PET) ≤1.44 predicted significant CAD with 82% sensitivity and 87% specificity, and MPR(CMR) ≤1.45 predicted significant CAD with 82% sensitivity and 81% specificity.</p><p>CONCLUSIONS: There is good correlation between MPR(CMR) and MPR(PET.) For the detection of significant CAD, MPR(PET) and MPR(CMR) seem comparable and very accurate. However, absolute perfusion values from PET and CMR are only weakly correlated; therefore, although quantitative CMR is clinically useful, further refinements are still required.</p>},
  author       = {Morton, Geraint and Chiribiri, Amedeo and Ishida, Masaki and Hussain, Shazia T and Schuster, Andreas and Indermuehle, Andreas and Perera, Divaka and Knuuti, Juhani and Baker, Stacey and Hedström, Erik and Schleyer, Paul and O'Doherty, Michael J. and Barrington, Sally F. and Nagel, Eike},
  issn         = {0735-1097},
  keyword      = {Aged,Coronary Artery Disease,Female,Humans,Magnetic Resonance Imaging,Male,Middle Aged,Myocardial Perfusion Imaging,Positron-Emission Tomography,Reproducibility of Results,Clinical Trial,Comparative Study,Journal Article,Research Support, Non-U.S. Gov't},
  language     = {eng},
  month        = {10},
  number       = {16},
  pages        = {55--1546},
  publisher    = {Elsevier USA},
  series       = {Journal of the American College of Cardiology},
  title        = {Quantification of absolute myocardial perfusion in patients with coronary artery disease: comparison between cardiovascular magnetic resonance and positron emission tomography},
  url          = {http://dx.doi.org/10.1016/j.jacc.2012.05.052},
  volume       = {60},
  year         = {2012},
}