Diagnostic value of myocardial blood flow indices and perfusion assessment obtained during positron emission tomography with 13Nammonia combined with computer tomography and adenosine stress for detection multivessel coronary artery disease
Authors:
Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation
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Type: Original articles
DOI:
For citation: Golukhova E.Z., Aslanidis I.P., Shurupova I.V., Shakhova A.A., Rumyantseva M.G., Ekaeva I.V., Trifonova T.A. Diagnostic value of myocardial blood flow indices and perfusion assessment obtained during positron emission tomography with 13N-ammonia combined with computer tomography and adenosine stress for detectionmultivessel coronary artery disease. Creative Cardiology. 2022; 16 (3): 340–54 (in Russ.). DOI: 10.24022/1997-3187-2022-16-3-340-354
Received / Accepted: 20.02.2022 / 05.08.2022
Keywords: myocardial blood flow quantification coronary flow reserve positron emission tomography combined computed tomography 13N-ammonia myocardial perfusion
Abstract
Objective. This study was to determine which parameters of stress-positron emission tomography (PET/CT) with 13N-ammonia contribute to an accurate identification of multivessel obstructive disease in patients with chronic coronary artery disease.
Material and methods. Study included 129 patients with 70% and more stenotic coronary lesions detected by angiography: 81 with single-vessel and 48 with multivessel disease. Stress-PET/CT-13N-ammonia dynamic scans were performed, global absolute and semiquantitative indices were obtained during rest and stress as well as relative perfusion images (presence of perfusion defect (PD) on a polar maps) and regional myocardial flow reserve (MFR) values were quantified.
Results. Comparison of all PET/CT derived semiquantitative indices revealed significant difference between two groups, as well as for myocardial blood flow (MBF) and for MFR (р < 0.05). The presence of multivessel disease (MVD) was defined: as PD in 2 or 3 related territories by visual analysis (sensitivity 38% and specificity 78%), and reduced MFR in 2 or 3 coronary territories according quantitative regional assessment (sensitivity and specificity were 85% and 60% respectively). ROC-analyses were performed and the optimal cut-off values for the detection of MVD for semiquantitative indices were: summed stress score (SSS) 10 and more with sensitivity and specificity 77% and 53% (AUC 0.703, p < 0.001), summed difference score (SDS) 8 (79% and 57% respectively, AUC 0.714, р < 0.001) and more; for absolute parameters – stress MBF 1.84 ml/min/g and less with sensitivity 60% and specificity 51% (AUC 0,668, р < 0.001); MFR 2.5 and less (81% and 58% respectively, AUC 0.775, р < 0.001).
Conclusion. Optimal criteria for the detection of significant MVD were: reduce of regional MFR in 2 or 3 coronary territories, optimal cut off for global values were SDS 8 and more and MFR 2.5 and less.
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About Authors
- Elena Z. Golukhova, Dr. Med. Sci., Professor, Academician of Russian Academy of Sciences, Director; ORCID
- Irakliy P. Aslanidis, Dr. Med. Sci., Professor, Head of Department; ORCID
- Irina V. Shurupova, Dr. Med. Sci., Leading Research Associate, Radiologist; ORCID
- Margarita G. Rumyantseva, Сand. Med. Sci., Senior Research Associate, Radiologist; ORCID
- Anzhelika A. Shakhova, Postgraduate; ORCID
- Irina V. Ekaeva, Сand. Chem. Sci., Leading Research Associate; ORCID
- Tat’yana A. Trifonova, Cand. Med. Sci., Head of Department; ORCID