Clinical impact of quantitative [15O] H2O PET/CT myocardial perfusion imaging on decision-making regarding invasive management of coronary artery disease

J Nucl Cardiol. 2022 Aug;29(4):1887-1899. doi: 10.1007/s12350-021-02604-y. Epub 2021 Apr 6.

Abstract

Background: This study was performed to determine the impact of oxygen-15-labeled water ([15O] H2O) positron emission tomography/computed tomography (PET/CT) myocardial perfusion imaging (MPI) on referral for invasive coronary angiography (ICA) and revascularization.

Methods: This study involved 57 patients who underwent [15O] H2O PET/CT MPI for evaluation of coronary artery disease (CAD). Data of referral for ICA and revascularization, clinical symptoms, and cardiac events within 6 months after MPI were assessed. Logistic regression was used to determine the predictors for referral and revascularization. The diagnostic values of hyperemic myocardial blood flow (MBF) and coronary flow reserve (CFR) were calculated.

Results: Normal and abnormal MPI findings were observed in 18 (32%) and 39 (68%) patients, respectively. The referral rate was significantly different between the normal and abnormal MPI groups (5.6% and 48.7%, respectively; P = .002). Revascularization rate of abnormal MPI group was 40.0%. There were significant differences of hyperemic MBF and CFR between patients with and without referral. Hyperemic MBF was significant predictor for referral (OR 15.24, 95% CI 3.39-68.55, P < .005) and revascularization (OR 28.57, 95% CI 3.08-265.33, P < .005).

Conclusion: [15O] H2O PET/CT MPI showed a clinical impact on decision-making regarding invasive procedure for management of CAD.

MeSH terms

  • Coronary Angiography / methods
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / surgery
  • Humans
  • Hyperemia*
  • Myocardial Perfusion Imaging* / methods
  • Positron Emission Tomography Computed Tomography
  • Positron-Emission Tomography / methods