Noninvasive assessment of coronary stenoses by myocardial perfusion imaging during pharmacologic coronary vasodilation. VIII. Clinical feasibility of positron cardiac imaging without a cyclotron using generator-produced rubidium-82

Journal Article · Tue Apr 01 00:00:00 EST 1986 · J. Am. Coll. Cardiol.; (United States)

DOI:https://doi.org/10.1016/S0735-1097(86)80336-9· OSTI ID:5809891

Gould, K L; Goldstein, R A; Mullani, N A; Kirkeeide, R L; Wong, W H; Tewson, T J; Berridge, M S; Bolomey, L A; Hartz, R K; Smalling, R W

The purpose of this study was to determine the clinical feasibility of diagnosing significant coronary artery disease by positron imaging of myocardial perfusion without a cyclotron, using generator-produced rubidium-82 (/sup 82/Rb). Fifty patients underwent positron emission tomography of the entire heart using a multislice positron camera and intravenous /sup 82/Rb or nitrogen-13 ammonia (/sup 13/NH/sub 3/) before and after intravenous dipyridamole combined with handgrip stress. Images were read by two observers blinded as to clinical or arteriographic data. Automated quantitative coronary arteriography was obtained for the arteriographic determination of coronary flow reserve, previously demonstrated to be a single integrated measure of stenosis severity accounting for all its geometric dimensions of length, absolute diameter, percent narrowing and asymmetry by quantitative analysis of cine films. Significant coronary artery disease was defined as an arteriographically determined coronary flow reserve of less than 3.0 based on all stenosis dimensions. Any single geometric measure of stenosis severity alone was an inadequate reference standard for comparison with perfusion images. Sensitivity of identifying patients with coronary artery disease having an arteriographically determined coronary flow reserve of less than 3.0 was 95% by positron imaging with a specificity of 100%. The single case that was missed, studied with /sup 13/NH/sub 3/, had a 43% diameter narrowing of a small ramus intermedius off the left coronary artery with no significant narrowing of the major coronary arteries. Positron emission tomography of myocardial perfusion before and after intravenous dipyridamole combined with handgrip stress utilizing generator-produced /sup 82/Rb provides sensitive and specific diagnosis of reduced coronary flow reserve due to coronary artery disease in humans.

• Research Organization: Univ. of Texas Medical School, Houston
• OSTI ID: 5809891
• Journal Information: J. Am. Coll. Cardiol.; (United States), Vol. 4
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARDIOVASCULAR DISEASES
DIAGNOSIS
CORONARIES
BLOOD FLOW
VASODILATION
FEASIBILITY STUDIES
MYOCARDIUM
PATIENTS
PERFUSED ORGANS
POSITRON COMPUTED TOMOGRAPHY
RUBIDIUM 82
ALKALI METAL ISOTOPES
ARTERIES
BETA DECAY RADIOISOTOPES
BETA-PLUS DECAY RADIOISOTOPES
BLOOD VESSELS
BODY
CARDIOVASCULAR SYSTEM
COMPUTERIZED TOMOGRAPHY
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
EMISSION COMPUTED TOMOGRAPHY
HEART
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
ISOTOPES
MINUTES LIVING RADIOISOTOPES
MUSCLES
NUCLEI
ODD-ODD NUCLEI
ORGANS
RADIOISOTOPES
RUBIDIUM ISOTOPES
TOMOGRAPHY
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