head-to-head comparison of the diagnostic performances of rubidium-pet and spect with czt camera for the detection of myocardial ischemia in a population of women and overweight individuals

The aim of this study was to compare the diagnostic performances for the detection of myocardial ischemia of 82-rb-pet-mps and 99m-tc-spect-mps in overweight individuals and women. men with bmi ≥ 25 and women referred for mps were considered for inclusion. all individuals underwent 99m-tc-spect-mps with czt cameras and 82-rb-pet-mps in 3d-mode. individuals with at least one positive mps were referred for coronary angiography (ca) with ffr measurements. a criterion for positivity was a composite endpoint including significant stenosis on ca or, in the absence of ca, the occurrence of acute coronary event during the following year. 313 patients (46% women) with mean bmi of 31.8 ± 6.5 were included. sensitivity for the detection of myocardial ischemia was higher with 82-rb-pet-mps compared with 99m-tc-spect-mps (85% vs. 57%, p < .05); specificity was equally high with both imaging techniques (93% vs. 94%, p > .05). 82-rb-pet allowed for a more accurate detection of patients with a high-risk coronary artery disease (hr-cad) than 99m-tc-spect-mps (auc = 0.86 vs. 0.75, respectively; p = .04). in women and overweight individuals, 82-rb-pet-mps provides higher sensitivity for the detection of myocardial ischemia than 99m-tc-spect-mps thanks to a better image quality and an improved detection of hr-cad.