⁸²Rb PET myocardial perfusion imaging is superior to ^99mTc-labelled agent SPECT in patients with known or suspected coronary artery disease

Purpose We compared the quality, interpretive confidence and interreader agreement between SPECT and PET myocardial perfusion imaging (MPI) in the same group of patients. Methods The study group comprised 27 patients (age 55±8.5 years, 12 men) with known or suspected coronary artery disease (CAD) who had undergone gated rest/stress MPI with 99mTc-labelled agent SPECT (with and without attenuation correction, AC), and subsequent clinical confirmation with 82Rb PET. Three experienced readers blinded to the clinical information interpreted all MPI studies. Results Interreader agreement was significantly superior for PET studies than for SPECT studies. Following consensus interpretation, the quality of 22 % of the non-AC SPECT studies, 33 % of the AC SPECT studies and 63 % of the PET studies was assessed as excellent or good (p00.016). Interpretations were definitely normal or abnormal in 7 % of non-AC SPECTstudies, 30%of AC SPECTstudies and 85% of PET studies (p00.046). In 13 patients who had received either invasive coronary angiography or CT angiography with no significant CAD, the true-positive rate for significant CAD was higher for PET, and the true-negative rate was equal for PET and AC SPECT, and lower for non-AC SPECT. Conclusion 82Rb PET MPI, used as a confirmatory test after SPECT, offers improved image quality, interpretive confidence and interreader agreement. © Springer-Verlag 2012.