15-O-water myocardial flow reserve PET and CT angiography by full hybrid PET/CT as a potential alternative to invasive angiography

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Combined myocardial flow reserve (MFR) by PET and CT coronary angiography (CTA) is a promising tool for assessment of coronary artery disease. Prior analyses of MFR/CTA has been performed as side-by-side interpretation, not as volume rendered, full hybrid analysis, with fused MFR/CTA. We aimed to: (i) establish a method for full hybrid analysis of MFR/CTA, (ii) validate the inter- and intra-observer reproducibility of MFR values, and (iii) determine the diagnostic value of side-by-side versus full hybrid MFR/CTA with 15-O-water PET. Forty-four outpatients scheduled for invasive coronary angiography (ICA) were enrolled prospectively. All underwent rest/stress 15-O-water PET/CTA with ICA as reference. Within two observers of different experience, the Pearson r at global and territorial level exceeded 0.953 for rest, stress, and MFR values, as determined by Carimas software. Within and between observers, the mean differences between rest, stress, and MFR values were close to zero and the confidence intervals for 95% limits of agreement were narrow. The diagnostic performance of full hybrid PET/CTA did not outperform the side-by-side approach, but performed better than MFR without CTA at vessel level: specificity 93% (95% confidence limits: 89-97%) versus 76% (64-88%), p = 0.0004; positive predictive value 71% (55-86%) versus 51% (37-65%), p = 0.0001; accuracy 90% (84-95%) versus 77% (69-84%), p = 0.0009. MFR showed high reproducibility within and between observers of different experience. The full hybrid model was not superior to side-by-side interpretation of MFR/CTA, but proved better than MFR alone at vessel level with regard to specificity, positive predictive value, and accuracy.

OriginalsprogEngelsk
TidsskriftThe international journal of cardiovascular imaging
Vol/bind34
Udgave nummer12
Sider (fra-til)2011–2022
ISSN1569-5794
DOI
StatusUdgivet - dec. 2018

Fingeraftryk

Coronary Angiography
Computed Tomography Angiography
Coronary Artery Disease
Outpatients
Confidence Intervals

Citer dette

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title = "15-O-water myocardial flow reserve PET and CT angiography by full hybrid PET/CT as a potential alternative to invasive angiography",
abstract = "Combined myocardial flow reserve (MFR) by PET and CT coronary angiography (CTA) is a promising tool for assessment of coronary artery disease. Prior analyses of MFR/CTA has been performed as side-by-side interpretation, not as volume rendered, full hybrid analysis, with fused MFR/CTA. We aimed to: (i) establish a method for full hybrid analysis of MFR/CTA, (ii) validate the inter- and intra-observer reproducibility of MFR values, and (iii) determine the diagnostic value of side-by-side versus full hybrid MFR/CTA with 15-O-water PET. Forty-four outpatients scheduled for invasive coronary angiography (ICA) were enrolled prospectively. All underwent rest/stress 15-O-water PET/CTA with ICA as reference. Within two observers of different experience, the Pearson r at global and territorial level exceeded 0.953 for rest, stress, and MFR values, as determined by Carimas software. Within and between observers, the mean differences between rest, stress, and MFR values were close to zero and the confidence intervals for 95{\%} limits of agreement were narrow. The diagnostic performance of full hybrid PET/CTA did not outperform the side-by-side approach, but performed better than MFR without CTA at vessel level: specificity 93{\%} (95{\%} confidence limits: 89-97{\%}) versus 76{\%} (64-88{\%}), p = 0.0004; positive predictive value 71{\%} (55-86{\%}) versus 51{\%} (37-65{\%}), p = 0.0001; accuracy 90{\%} (84-95{\%}) versus 77{\%} (69-84{\%}), p = 0.0009. MFR showed high reproducibility within and between observers of different experience. The full hybrid model was not superior to side-by-side interpretation of MFR/CTA, but proved better than MFR alone at vessel level with regard to specificity, positive predictive value, and accuracy.",
keywords = "CT angiography, Diagnostic value, Flow reserve, PET 15-O-water, Reproducibility, Predictive Value of Tests, Prospective Studies, Humans, Middle Aged, Male, Aged, 80 and over, Adult, Female, Positron Emission Tomography Computed Tomography/methods, Coronary Angiography/methods, Coronary Circulation, Myocardial Perfusion Imaging/methods, Reproducibility of Results, Computed Tomography Angiography/methods, Multidetector Computed Tomography/methods, Oxygen Radioisotopes/administration & dosage, Coronary Artery Disease/diagnostic imaging, Aged, Coronary Vessels/diagnostic imaging, Observer Variation",
author = "Anders Thomassen and Poul-Erik Braad and Pedersen, {Kasper T} and Henrik Petersen and Allan Johansen and Diederichsen, {Axel C P} and Hans Mickley and Jensen, {Lisette O} and Juhani Knuuti and Oke Gerke and H{\o}ilund-Carlsen, {Poul F}",
year = "2018",
month = "12",
doi = "10.1007/s10554-018-1420-3",
language = "English",
volume = "34",
pages = "2011–2022",
journal = "International Journal of Cardiovascular Imaging",
issn = "1569-5794",
publisher = "Springer",
number = "12",

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TY - JOUR

T1 - 15-O-water myocardial flow reserve PET and CT angiography by full hybrid PET/CT as a potential alternative to invasive angiography

AU - Thomassen, Anders

AU - Braad, Poul-Erik

AU - Pedersen, Kasper T

AU - Petersen, Henrik

AU - Johansen, Allan

AU - Diederichsen, Axel C P

AU - Mickley, Hans

AU - Jensen, Lisette O

AU - Knuuti, Juhani

AU - Gerke, Oke

AU - Høilund-Carlsen, Poul F

PY - 2018/12

Y1 - 2018/12

N2 - Combined myocardial flow reserve (MFR) by PET and CT coronary angiography (CTA) is a promising tool for assessment of coronary artery disease. Prior analyses of MFR/CTA has been performed as side-by-side interpretation, not as volume rendered, full hybrid analysis, with fused MFR/CTA. We aimed to: (i) establish a method for full hybrid analysis of MFR/CTA, (ii) validate the inter- and intra-observer reproducibility of MFR values, and (iii) determine the diagnostic value of side-by-side versus full hybrid MFR/CTA with 15-O-water PET. Forty-four outpatients scheduled for invasive coronary angiography (ICA) were enrolled prospectively. All underwent rest/stress 15-O-water PET/CTA with ICA as reference. Within two observers of different experience, the Pearson r at global and territorial level exceeded 0.953 for rest, stress, and MFR values, as determined by Carimas software. Within and between observers, the mean differences between rest, stress, and MFR values were close to zero and the confidence intervals for 95% limits of agreement were narrow. The diagnostic performance of full hybrid PET/CTA did not outperform the side-by-side approach, but performed better than MFR without CTA at vessel level: specificity 93% (95% confidence limits: 89-97%) versus 76% (64-88%), p = 0.0004; positive predictive value 71% (55-86%) versus 51% (37-65%), p = 0.0001; accuracy 90% (84-95%) versus 77% (69-84%), p = 0.0009. MFR showed high reproducibility within and between observers of different experience. The full hybrid model was not superior to side-by-side interpretation of MFR/CTA, but proved better than MFR alone at vessel level with regard to specificity, positive predictive value, and accuracy.

AB - Combined myocardial flow reserve (MFR) by PET and CT coronary angiography (CTA) is a promising tool for assessment of coronary artery disease. Prior analyses of MFR/CTA has been performed as side-by-side interpretation, not as volume rendered, full hybrid analysis, with fused MFR/CTA. We aimed to: (i) establish a method for full hybrid analysis of MFR/CTA, (ii) validate the inter- and intra-observer reproducibility of MFR values, and (iii) determine the diagnostic value of side-by-side versus full hybrid MFR/CTA with 15-O-water PET. Forty-four outpatients scheduled for invasive coronary angiography (ICA) were enrolled prospectively. All underwent rest/stress 15-O-water PET/CTA with ICA as reference. Within two observers of different experience, the Pearson r at global and territorial level exceeded 0.953 for rest, stress, and MFR values, as determined by Carimas software. Within and between observers, the mean differences between rest, stress, and MFR values were close to zero and the confidence intervals for 95% limits of agreement were narrow. The diagnostic performance of full hybrid PET/CTA did not outperform the side-by-side approach, but performed better than MFR without CTA at vessel level: specificity 93% (95% confidence limits: 89-97%) versus 76% (64-88%), p = 0.0004; positive predictive value 71% (55-86%) versus 51% (37-65%), p = 0.0001; accuracy 90% (84-95%) versus 77% (69-84%), p = 0.0009. MFR showed high reproducibility within and between observers of different experience. The full hybrid model was not superior to side-by-side interpretation of MFR/CTA, but proved better than MFR alone at vessel level with regard to specificity, positive predictive value, and accuracy.

KW - CT angiography

KW - Diagnostic value

KW - Flow reserve

KW - PET 15-O-water

KW - Reproducibility

KW - Predictive Value of Tests

KW - Prospective Studies

KW - Humans

KW - Middle Aged

KW - Male

KW - Aged, 80 and over

KW - Adult

KW - Female

KW - Positron Emission Tomography Computed Tomography/methods

KW - Coronary Angiography/methods

KW - Coronary Circulation

KW - Myocardial Perfusion Imaging/methods

KW - Reproducibility of Results

KW - Computed Tomography Angiography/methods

KW - Multidetector Computed Tomography/methods

KW - Oxygen Radioisotopes/administration & dosage

KW - Coronary Artery Disease/diagnostic imaging

KW - Aged

KW - Coronary Vessels/diagnostic imaging

KW - Observer Variation

U2 - 10.1007/s10554-018-1420-3

DO - 10.1007/s10554-018-1420-3

M3 - Journal article

VL - 34

SP - 2011

EP - 2022

JO - International Journal of Cardiovascular Imaging

JF - International Journal of Cardiovascular Imaging

SN - 1569-5794

IS - 12

ER -