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]. Chronic Chest Pain-High Probability of CAD 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 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 a combined stress Rb-82 PET perfusion imaging and CCTA, nearly half of significant angiographic stenoses (47%) occurred without evidence of ischemia, whereas 50% of normal PET studies were associated with some CCTA abnormality [61]. SPECT or SPECT/CT MPI Rest and Stress Stress SPECT MPI can identify relative myocardial perfusion defects, indicating the presence of myocardial ischemia and/or infarction. By acquiring rest and stress perfusion scans, it is possible to demonstrate reversibility (ischemia) or irreversibility (infarction) of a myocardial perfusion defect. The territory of the perfusion defect identifies the likely coronary artery involved and can usually distinguish between significant single-vessel and multivessel coronary arterial obstructions.
Chronic Chest Pain High Probability of Coronary Artery Disease PCAs. 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]. Chronic Chest Pain-High Probability of CAD 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 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 a combined stress Rb-82 PET perfusion imaging and CCTA, nearly half of significant angiographic stenoses (47%) occurred without evidence of ischemia, whereas 50% of normal PET studies were associated with some CCTA abnormality [61]. SPECT or SPECT/CT MPI Rest and Stress Stress SPECT MPI can identify relative myocardial perfusion defects, indicating the presence of myocardial ischemia and/or infarction. By acquiring rest and stress perfusion scans, it is possible to demonstrate reversibility (ischemia) or irreversibility (infarction) of a myocardial perfusion defect. The territory of the perfusion defect identifies the likely coronary artery involved and can usually distinguish between significant single-vessel and multivessel coronary arterial obstructions.