SNMMI: FDG PET bests MPI in detecting early stage CAD

F-18 FDG PET is superior to stress myocardial perfusion imaging (MPI) in detecting coronary artery disease (CAD), particularly single-vessel disease, according to research presented at the Society of Nuclear Medicine and Molecular Imaging’s 2013 annual meeting in Vancouver.

“By detecting the detrimental changes in the heart at an early stage, physicians can prescribe medications that can halt disease progression, thus preventing a devastating cardiac event such as heart attack or sudden cardiac death,” Arun Sasikumar, MD, MBBS, lead researcher from the department of nuclear medicine at the Post Graduate Institute of Medical Education and Research (PGIMER) based in Chandigarh, India, said in a release.

Sasikumar and colleagues compared stress 99m tetrofosmin MPI with stress F-18 FDG cardiac PET in a group of 45 patients with suspected CAD, but no history of heart attack. Angiography served as a baseline to compare the two molecular imaging methods.

A total of 27 patients had abnormal angiograms with at least one artery narrowed by more than 50 percent. Seventeen patients had single-vessel disease, five had double-vessel disease and another five had triple-vessel disease.

Although results between MPI and FDG PET were similar for multivessel disease, FDG PET was shown to be far superior at imaging single-vessel disease, according to Sasikumar and colleagues.

In detecting stenosis of greater than 50 percent, FDG PET demonstrated sensitivity and specificity of 96 percent and 76 percent, respectively. MPI delivered sensitivity and specificity of 56 percent and 62 percent, respectively, according to the researchers.

“FDG-PET imaging can detect ischemia at a very early stage, even before significant symptoms appear. This molecular imaging technique could potentially be used for initial CAD screening to help doctors better determine a patient’s cardiac risk and manage the care of these patients, who would otherwise be considered to have normal cardiovascular function,” added Sasikumar.