P16 Rubidium myocardial perfusion PET-CT: initial experience in first 100 patients

Abstract

Introduction Positron Emission Tomography/Computed Tomography (PET/CT) has many advantages over Single Photon Emission Computed Tomography in Myocardial Perfusion Imaging (MPI). However, UK availability, has been limited. We describe a new Rubidium (Rb) PET MPI service; the third in the National Health Service in England. Methods Audit of the first 100 patients from November 2019 to January 2020. 66 men, 34 women, mean age 65 ±11, mean Body Mass Index 28.3 ±6.8. Imaging comprised CT for attenuation correction, CT for Agatston scoring if no known Coronary Artery Disease (CAD) or prior intervention, and PET with and without adenosine vasodilation. Results The commonest indication was symptoms post-revascularization (36%). 31% had had previous percutaneous intervention, 15% had had previous coronary surgery. 21% had had prior cardiac CT. The mean wait from request to scan was 30 days. 98% were reported the same or next working day. 96% received 140 mcg/kg/min adenosine, 4% received 210 mcg/kg/min. Two patients did not show adequate vasodilation. All PET MPI scans were diagnostic quality. 43% had Agatston scoring. The mean total Agatston score was 511. The normalcy rate for PET MPS was 60%. The prevalence of infarction was 20%. The mean Myocardial Flow Reserve was 2.3 ±0.8. Conclusion Rb PET MPI is feasible and high quality in a new service. It provides detailed coronary assessment, with plaque burden, relative perfusion and absolute myocardial blood flow quantification. It will be an essential contributor to patient diagnosis, treatment response and risk stratification.