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J Nucl Med. 2008; 49 (Supplement 1):191P
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Cardiovascular: Clinical Science

Clinical Science Posters

Characterizing the continuum of coronary artery disease by quantitative PET-CT

Mehrbod Javadi1, Riikka Lautamäki1, Jennifer Merrill1, Corina Voicu1 and Frank Bengel1

1 Johns Hopkins University, Baltimore, Maryland

830

Objectives: Integration of perfusion PET with CT angiography(CTA) allows for assessment of microvascular reactivity, atherosclerotic plaque burden, and regional ischemia in a single study. We sought to characterize different disease patterns in an intermediate risk population referred for workup of CAD.

Methods: Rest/dipyridamole Rb-82 PET-CT with CTA was performed in 35 consecutive pts on a 64-row GE Discovery Rx VCT PET-CT scanner. Rb-82 images were qualitatively evaluated for regional perfusion defects, and coronary flow reserve (CFR) was quantified using a previously validated retention model. CTA was visually analyzed to obtain a plaque burden score from vascular remodeling/noncalcified/calcified plaque in 17 coronary segments.

Results: Normal CTA was found in 11 pts, while 18 had atherosclerosis without and 6 with regional perfusion defects. Global CFR was significantly higher in normal CTA vs nonobstructive atherosclerosis and regional ischemia (2.5±0.4 vs 1.8±0.5 vs 1.5±0.2; p<0.05). In pts with nonobstructive atherosclerosis, there was a nonsignificant trend towards lower CFR with higher plaque burden (r=-0.35; p=0.09). Regionally, there was no significant difference of flow reserve between plaque-laden and plaque-free vascular territories in the same patient 1.9±0.5 vs 1.8±0.5; p=0.12). No difference in CFR was observed in predominantly calcified vs noncalcified atherosclerosis (1.9±0.5 vs 1.8±0.5; p=0.68).

Conclusions: Nonobstructive atherosclerosis is associated with decreased flow reserve even in morphologically plaque-free vascular territories, suggesting presence of global endothelial dysfunction. Integration of quantitative flow and coronary atherosclerosis allows for bio-morphologic characterization of early manifestations of coronary artery disease by hybrid PET-CT.





This Article
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Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
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Google Scholar
Right arrow Articles by Javadi, M.
Right arrow Articles by Bengel, F.
PubMed
Right arrow Articles by Javadi, M.
Right arrow Articles by Bengel, F.