A single-center prospective study of 510 patients with suspected CAD has shown that Rb-82 PET/CT has demonstrated sensitivity and specificity of 90% and 88% for the detection of obstructive coronary disease compared with ICA [52]. Among patients with suspected CAD, gated Rb-82 PET/CT can also identify a subset of patients with 3-vessel or left main coronary artery CAD [57]. A single-center study of 1,432 patients with known or suspected CAD has shown that the inherent ability of Rb-82 PET/CT to collect LV function data at rest and during peak stress leads to an improved detection of multivessel CAD [58]. LVEF reserve provides significant independent and incremental value to Rb-82 MPI for predicting the risk of left main/3-vessel disease [57] and future adverse events [59]. A multicenter registry study included 7,061 patients with known or suspected CAD who underwent a clinically indicated rest/stress Rb-82 PET MPI (66% of patients had chronic chest pain as the reason for the test). The extent and severity of ischemia and scarring on Rb-82 PET MPI provided powerful and incremental risk estimates of cardiac death and all-cause death compared with traditional coronary risk factors [60]. PET/CT and CCTA Hybrid PET scanners use CT for attenuation correction (PET/CT) following completion of the PET study. By coupling the PET perfusion examination findings to a CCTA, PET/CT permits the fusion of complementary anatomic coronary arterial and functional (perfusion) myocardial information and enhances diagnostic accuracy [60]. The results of the combined examinations can more accurately identify patients for revascularization. In a study of 110 consecutive patients with combined stress Rb-82 PET perfusion imaging and CCTA, nearly half of the significant angiographic stenoses (47%) occurred without evidence of ischemia, whereas 50% of normal PET studies were associated with some CCTA abnormality [61].
Chronic Chest Pain High Probability of Coronary Artery Disease PCAs. A single-center prospective study of 510 patients with suspected CAD has shown that Rb-82 PET/CT has demonstrated sensitivity and specificity of 90% and 88% for the detection of obstructive coronary disease compared with ICA [52]. Among patients with suspected CAD, gated Rb-82 PET/CT can also identify a subset of patients with 3-vessel or left main coronary artery CAD [57]. A single-center study of 1,432 patients with known or suspected CAD has shown that the inherent ability of Rb-82 PET/CT to collect LV function data at rest and during peak stress leads to an improved detection of multivessel CAD [58]. LVEF reserve provides significant independent and incremental value to Rb-82 MPI for predicting the risk of left main/3-vessel disease [57] and future adverse events [59]. A multicenter registry study included 7,061 patients with known or suspected CAD who underwent a clinically indicated rest/stress Rb-82 PET MPI (66% of patients had chronic chest pain as the reason for the test). The extent and severity of ischemia and scarring on Rb-82 PET MPI provided powerful and incremental risk estimates of cardiac death and all-cause death compared with traditional coronary risk factors [60]. PET/CT and CCTA Hybrid PET scanners use CT for attenuation correction (PET/CT) following completion of the PET study. By coupling the PET perfusion examination findings to a CCTA, PET/CT permits the fusion of complementary anatomic coronary arterial and functional (perfusion) myocardial information and enhances diagnostic accuracy [60]. The results of the combined examinations can more accurately identify patients for revascularization. In a study of 110 consecutive patients with combined stress Rb-82 PET perfusion imaging and CCTA, nearly half of the significant angiographic stenoses (47%) occurred without evidence of ischemia, whereas 50% of normal PET studies were associated with some CCTA abnormality [61].