Hidesato Fujito, Mark Lemley, Valerie Builoff, Wenhao Zhang, Keiichiro Kuronuma, Giselle Ramirez, Aditya Killekar, Joanna X Liang, Paul Kavanagh, Mark C Hyun, Sean W Hayes, Louise E J Thomson, John D Friedman, Serge D Van Kriekinge, Marcelo F Di Carli, Damini Dey, Daniel S Berman, Piotr J Slomka
{"title":"82Rb PET心肌血流定量：动脉输入曲线质量对诊断准确性的影响。","authors":"Hidesato Fujito, Mark Lemley, Valerie Builoff, Wenhao Zhang, Keiichiro Kuronuma, Giselle Ramirez, Aditya Killekar, Joanna X Liang, Paul Kavanagh, Mark C Hyun, Sean W Hayes, Louise E J Thomson, John D Friedman, Serge D Van Kriekinge, Marcelo F Di Carli, Damini Dey, Daniel S Berman, Piotr J Slomka","doi":"10.1016/j.nuclcard.2025.102270","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>We investigated whether the shape of arterial blood input curves affects the diagnostic performance of myocardial blood flow (MBF) on Rubidium-82 (<sup>82</sup>Rb) PET myocardial perfusion imaging (MPI) for obstructive coronary artery disease (CAD).</p><p><strong>Methods and results: </strong>We retrospectively enrolled 386 patients without prior CAD who underwent <sup>82</sup>Rb PET-MPI and invasive coronary angiography within 6 months, from 2010 to 2018. Abnormal shapes of stress left atrial blood pool (BP) time activity curve (TAC) were characterized into five categories based on visual/quantitative assessment: (1) low stress/rest peak ratio (SRPR), (2) slow activity rise, (3) slow activity decline, (4) broad peak and (5) multiple peaks. SRPR was defined as the ratio of peak count value on the stress BP activity by rest BP activity. Low SRPR was defined as below the median value (0.82). We compared the diagnostic performance of stress MBF and myocardial flow reserve (MFR) for detecting obstructive CAD (≥70% stenosis) using area under the curve (AUC) analysis. Among five abnormal categories, the AUC of stress MBF in the low SRPR (n=193) group was lower than in the normal SRPR (n=193) group in per-patient (0.67 [0.59-0.74] vs. 0.78 [0.70-0.84], p=0.0499) and per-vessel analysis (0.68 [0.63-0.73] vs. 0.75 [0.71-0.79], p=0.0352). The AUC in slow activity rise group (n=167) for stress MBF was lower than in others in per-vessel analysis (n=219) (0.68 [0.62-0.72] vs. 0.75 [0.70-0.79], p=0.0270). Other abnormal profiles showed no significant differences (all p>0.05).</p><p><strong>Conclusions: </strong>Low SRPR and slow activity rise were associated with reduced diagnostic performance of stress MBF.</p>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102270"},"PeriodicalIF":3.0000,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"<sup>82</sup>Rb PET Myocardial Blood Flow Quantification: Influence of Arterial Input Curve Quality on Diagnostic Accuracy.\",\"authors\":\"Hidesato Fujito, Mark Lemley, Valerie Builoff, Wenhao Zhang, Keiichiro Kuronuma, Giselle Ramirez, Aditya Killekar, Joanna X Liang, Paul Kavanagh, Mark C Hyun, Sean W Hayes, Louise E J Thomson, John D Friedman, Serge D Van Kriekinge, Marcelo F Di Carli, Damini Dey, Daniel S Berman, Piotr J Slomka\",\"doi\":\"10.1016/j.nuclcard.2025.102270\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>We investigated whether the shape of arterial blood input curves affects the diagnostic performance of myocardial blood flow (MBF) on Rubidium-82 (<sup>82</sup>Rb) PET myocardial perfusion imaging (MPI) for obstructive coronary artery disease (CAD).</p><p><strong>Methods and results: </strong>We retrospectively enrolled 386 patients without prior CAD who underwent <sup>82</sup>Rb PET-MPI and invasive coronary angiography within 6 months, from 2010 to 2018. Abnormal shapes of stress left atrial blood pool (BP) time activity curve (TAC) were characterized into five categories based on visual/quantitative assessment: (1) low stress/rest peak ratio (SRPR), (2) slow activity rise, (3) slow activity decline, (4) broad peak and (5) multiple peaks. SRPR was defined as the ratio of peak count value on the stress BP activity by rest BP activity. Low SRPR was defined as below the median value (0.82). We compared the diagnostic performance of stress MBF and myocardial flow reserve (MFR) for detecting obstructive CAD (≥70% stenosis) using area under the curve (AUC) analysis. Among five abnormal categories, the AUC of stress MBF in the low SRPR (n=193) group was lower than in the normal SRPR (n=193) group in per-patient (0.67 [0.59-0.74] vs. 0.78 [0.70-0.84], p=0.0499) and per-vessel analysis (0.68 [0.63-0.73] vs. 0.75 [0.71-0.79], p=0.0352). The AUC in slow activity rise group (n=167) for stress MBF was lower than in others in per-vessel analysis (n=219) (0.68 [0.62-0.72] vs. 0.75 [0.70-0.79], p=0.0270). Other abnormal profiles showed no significant differences (all p>0.05).</p><p><strong>Conclusions: </strong>Low SRPR and slow activity rise were associated with reduced diagnostic performance of stress MBF.</p>\",\"PeriodicalId\":16476,\"journal\":{\"name\":\"Journal of Nuclear Cardiology\",\"volume\":\" \",\"pages\":\"102270\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-06-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Nuclear Cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.nuclcard.2025.102270\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Nuclear Cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.nuclcard.2025.102270","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
82Rb PET Myocardial Blood Flow Quantification: Influence of Arterial Input Curve Quality on Diagnostic Accuracy.
Background: We investigated whether the shape of arterial blood input curves affects the diagnostic performance of myocardial blood flow (MBF) on Rubidium-82 (82Rb) PET myocardial perfusion imaging (MPI) for obstructive coronary artery disease (CAD).
Methods and results: We retrospectively enrolled 386 patients without prior CAD who underwent 82Rb PET-MPI and invasive coronary angiography within 6 months, from 2010 to 2018. Abnormal shapes of stress left atrial blood pool (BP) time activity curve (TAC) were characterized into five categories based on visual/quantitative assessment: (1) low stress/rest peak ratio (SRPR), (2) slow activity rise, (3) slow activity decline, (4) broad peak and (5) multiple peaks. SRPR was defined as the ratio of peak count value on the stress BP activity by rest BP activity. Low SRPR was defined as below the median value (0.82). We compared the diagnostic performance of stress MBF and myocardial flow reserve (MFR) for detecting obstructive CAD (≥70% stenosis) using area under the curve (AUC) analysis. Among five abnormal categories, the AUC of stress MBF in the low SRPR (n=193) group was lower than in the normal SRPR (n=193) group in per-patient (0.67 [0.59-0.74] vs. 0.78 [0.70-0.84], p=0.0499) and per-vessel analysis (0.68 [0.63-0.73] vs. 0.75 [0.71-0.79], p=0.0352). The AUC in slow activity rise group (n=167) for stress MBF was lower than in others in per-vessel analysis (n=219) (0.68 [0.62-0.72] vs. 0.75 [0.70-0.79], p=0.0270). Other abnormal profiles showed no significant differences (all p>0.05).
Conclusions: Low SRPR and slow activity rise were associated with reduced diagnostic performance of stress MBF.
期刊介绍：
Journal of Nuclear Cardiology is the only journal in the world devoted to this dynamic and growing subspecialty. Physicians and technologists value the Journal not only for its peer-reviewed articles, but also for its timely discussions about the current and future role of nuclear cardiology. Original articles address all aspects of nuclear cardiology, including interpretation, diagnosis, imaging equipment, and use of radiopharmaceuticals. As the official publication of the American Society of Nuclear Cardiology, the Journal also brings readers the latest information emerging from the Society''s task forces and publishes guidelines and position papers as they are adopted.
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