Noninvasive assessment of coronary stenoses by myocardial perfusion imaging during pharmacologic coronary vasodilation. VIII. Clinical feasibility of positron cardiac imaging without a cyclotron using generator-produced Rubidium-82

K. Lance Gould; Richard A. Goldstein; Nizar A. Mullani; Richard L. Kirkeeide; Wai Hoi Wong; Timothy J. Tewson; Marc S. Berridge; Leonard A. Bolomey; Ross K. Hartz; Richard W. Smalling; Francisco Fuentes; Akira Nishikawa

doi:10.1016/S0735-1097(86)80336-9

Noninvasive assessment of coronary stenoses by myocardial perfusion imaging during pharmacologic coronary vasodilation. VIII. Clinical feasibility of positron cardiac imaging without a cyclotron using generator-produced Rubidium-82

K. Lance Gould, Richard A. Goldstein, Nizar A. Mullani, Richard L. Kirkeeide, Wai Hoi Wong, Timothy J. Tewson, Marc S. Berridge, Leonard A. Bolomey, Ross K. Hartz, Richard W. Smalling, Francisco Fuentes, Akira Nishikawa

Cancer Systems Imaging

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Abstract

The purpose of this study was to determine the clinical feasibility of diagnosing significant coronary artery disease by positron imaging of myocardial perfusion without a cyclotron, using generator-produced rubidium-82 (⁸²Rb). Fifty patients underwent positron emission tomography of the entire heart using a multislice positron camera and intravenous ⁸²Rb or nitrogen-13 ammonia (¹³NH₃) before and after intravenous dipyridamole combined with handgrip stress. Images were read by two observers blinded as to clinical or arteriographic data. Automated quantitative coronary arteriography was obtained for the arteriographic determination of coronary Row reserve, previously demonstrated to be a single integrated measure of stenosis severity accounting for all its geometric dimensions oflength, absolute diameter, percent narrowing and asymmetry by quantitative analysis of cine films. Significant coronary artery disease was defined as an arteriographicaUy determined coronary flow reserve of less than 3.0 based on all stenosis dimensions. Any single geometric measure of stenosis severity alone was an inadequate reference standard for comparison with perfusion images. Sensitivity of identifying patients with coronary artery disease having an arteriographically determined coronary Row reserve of less than 3.0 was 95% by positron imaging with a specificity of 100%. The single case that was missed, studied with ¹³NH₃ had a 43% diameter narrowing of a small ramus intermedius otT the left coronary artery with no significant narrowing of the major coronary arteries. Positron emission tomography of myocardial perfusion before and after intravenous dipyridamole combined with handgrip stress utilizing generator-produced ⁸²Rb provides sensitive and specific diagnosis of reduced coronary Row reserve due to coronary artery disease in humans.

Original language	English (US)
Pages (from-to)	775-789
Number of pages	15
Journal	Journal of the American College of Cardiology
Volume	7
Issue number	4
DOIs	https://doi.org/10.1016/S0735-1097(86)80336-9
State	Published - 1986

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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Gould, K. L., Goldstein, R. A., Mullani, N. A., Kirkeeide, R. L., Wong, W. H., Tewson, T. J., Berridge, M. S., Bolomey, L. A., Hartz, R. K., Smalling, R. W., Fuentes, F., & Nishikawa, A. (1986). Noninvasive assessment of coronary stenoses by myocardial perfusion imaging during pharmacologic coronary vasodilation. VIII. Clinical feasibility of positron cardiac imaging without a cyclotron using generator-produced Rubidium-82. Journal of the American College of Cardiology, 7(4), 775-789. https://doi.org/10.1016/S0735-1097(86)80336-9

Noninvasive assessment of coronary stenoses by myocardial perfusion imaging during pharmacologic coronary vasodilation. VIII. Clinical feasibility of positron cardiac imaging without a cyclotron using generator-produced Rubidium-82. / Gould, K. Lance; Goldstein, Richard A.; Mullani, Nizar A. et al.
In: Journal of the American College of Cardiology, Vol. 7, No. 4, 1986, p. 775-789.

Research output: Contribution to journal › Article › peer-review

Gould, KL, Goldstein, RA, Mullani, NA, Kirkeeide, RL, Wong, WH, Tewson, TJ, Berridge, MS, Bolomey, LA, Hartz, RK, Smalling, RW, Fuentes, F & Nishikawa, A 1986, 'Noninvasive assessment of coronary stenoses by myocardial perfusion imaging during pharmacologic coronary vasodilation. VIII. Clinical feasibility of positron cardiac imaging without a cyclotron using generator-produced Rubidium-82', Journal of the American College of Cardiology, vol. 7, no. 4, pp. 775-789. https://doi.org/10.1016/S0735-1097(86)80336-9

Gould KL, Goldstein RA, Mullani NA, Kirkeeide RL, Wong WH, Tewson TJ et al. Noninvasive assessment of coronary stenoses by myocardial perfusion imaging during pharmacologic coronary vasodilation. VIII. Clinical feasibility of positron cardiac imaging without a cyclotron using generator-produced Rubidium-82. Journal of the American College of Cardiology. 1986;7(4):775-789. doi: 10.1016/S0735-1097(86)80336-9

Gould, K. Lance ; Goldstein, Richard A. ; Mullani, Nizar A. et al. / Noninvasive assessment of coronary stenoses by myocardial perfusion imaging during pharmacologic coronary vasodilation. VIII. Clinical feasibility of positron cardiac imaging without a cyclotron using generator-produced Rubidium-82. In: Journal of the American College of Cardiology. 1986 ; Vol. 7, No. 4. pp. 775-789.

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title = "Noninvasive assessment of coronary stenoses by myocardial perfusion imaging during pharmacologic coronary vasodilation. VIII. Clinical feasibility of positron cardiac imaging without a cyclotron using generator-produced Rubidium-82",

abstract = "The purpose of this study was to determine the clinical feasibility of diagnosing significant coronary artery disease by positron imaging of myocardial perfusion without a cyclotron, using generator-produced rubidium-82 (82Rb). Fifty patients underwent positron emission tomography of the entire heart using a multislice positron camera and intravenous 82Rb or nitrogen-13 ammonia (13NH3) before and after intravenous dipyridamole combined with handgrip stress. Images were read by two observers blinded as to clinical or arteriographic data. Automated quantitative coronary arteriography was obtained for the arteriographic determination of coronary Row reserve, previously demonstrated to be a single integrated measure of stenosis severity accounting for all its geometric dimensions oflength, absolute diameter, percent narrowing and asymmetry by quantitative analysis of cine films. Significant coronary artery disease was defined as an arteriographicaUy determined coronary flow reserve of less than 3.0 based on all stenosis dimensions. Any single geometric measure of stenosis severity alone was an inadequate reference standard for comparison with perfusion images. Sensitivity of identifying patients with coronary artery disease having an arteriographically determined coronary Row reserve of less than 3.0 was 95% by positron imaging with a specificity of 100%. The single case that was missed, studied with 13NH3 had a 43% diameter narrowing of a small ramus intermedius otT the left coronary artery with no significant narrowing of the major coronary arteries. Positron emission tomography of myocardial perfusion before and after intravenous dipyridamole combined with handgrip stress utilizing generator-produced 82Rb provides sensitive and specific diagnosis of reduced coronary Row reserve due to coronary artery disease in humans.",

author = "Gould, {K. Lance} and Goldstein, {Richard A.} and Mullani, {Nizar A.} and Kirkeeide, {Richard L.} and Wong, {Wai Hoi} and Tewson, {Timothy J.} and Berridge, {Marc S.} and Bolomey, {Leonard A.} and Hartz, {Ross K.} and Smalling, {Richard W.} and Francisco Fuentes and Akira Nishikawa",

note = "Funding Information: From the University of Texas Medical School, Division of Cardiology, the Positron Diagnostic and Research Center (PDRC) and the Graduate School of Biomedical Sciences, University of Texas Health Science Center at Houston, Houston, Texas. This work was carried out as a joint collab• orative research project with the Clayton Foundation for Research and was supported in part by Grants ROIHL26862 and ROIHL26885 from the National Institutes of Health, Bethesda, Maryland and Grant DE-FG05-84ER6021O from the Department of Education, Washington, DC. Manuscript received July 31, 1985; revised manuscript received Oc• tober 30, 1985, accepted November 12, 1985. Address for reprints: K. Lance Gould, MD, University of Texas Med• ical School at Houston, Division of Cardiology, Box 20708, Houston, Texas 77025.",

year = "1986",

doi = "10.1016/S0735-1097(86)80336-9",

language = "English (US)",

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pages = "775--789",

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T1 - Noninvasive assessment of coronary stenoses by myocardial perfusion imaging during pharmacologic coronary vasodilation. VIII. Clinical feasibility of positron cardiac imaging without a cyclotron using generator-produced Rubidium-82

AU - Gould, K. Lance

AU - Goldstein, Richard A.

AU - Mullani, Nizar A.

AU - Kirkeeide, Richard L.

AU - Wong, Wai Hoi

AU - Tewson, Timothy J.

AU - Berridge, Marc S.

AU - Bolomey, Leonard A.

AU - Hartz, Ross K.

AU - Smalling, Richard W.

AU - Fuentes, Francisco

AU - Nishikawa, Akira

N1 - Funding Information: From the University of Texas Medical School, Division of Cardiology, the Positron Diagnostic and Research Center (PDRC) and the Graduate School of Biomedical Sciences, University of Texas Health Science Center at Houston, Houston, Texas. This work was carried out as a joint collab• orative research project with the Clayton Foundation for Research and was supported in part by Grants ROIHL26862 and ROIHL26885 from the National Institutes of Health, Bethesda, Maryland and Grant DE-FG05-84ER6021O from the Department of Education, Washington, DC. Manuscript received July 31, 1985; revised manuscript received Oc• tober 30, 1985, accepted November 12, 1985. Address for reprints: K. Lance Gould, MD, University of Texas Med• ical School at Houston, Division of Cardiology, Box 20708, Houston, Texas 77025.

PY - 1986

Y1 - 1986

N2 - The purpose of this study was to determine the clinical feasibility of diagnosing significant coronary artery disease by positron imaging of myocardial perfusion without a cyclotron, using generator-produced rubidium-82 (82Rb). Fifty patients underwent positron emission tomography of the entire heart using a multislice positron camera and intravenous 82Rb or nitrogen-13 ammonia (13NH3) before and after intravenous dipyridamole combined with handgrip stress. Images were read by two observers blinded as to clinical or arteriographic data. Automated quantitative coronary arteriography was obtained for the arteriographic determination of coronary Row reserve, previously demonstrated to be a single integrated measure of stenosis severity accounting for all its geometric dimensions oflength, absolute diameter, percent narrowing and asymmetry by quantitative analysis of cine films. Significant coronary artery disease was defined as an arteriographicaUy determined coronary flow reserve of less than 3.0 based on all stenosis dimensions. Any single geometric measure of stenosis severity alone was an inadequate reference standard for comparison with perfusion images. Sensitivity of identifying patients with coronary artery disease having an arteriographically determined coronary Row reserve of less than 3.0 was 95% by positron imaging with a specificity of 100%. The single case that was missed, studied with 13NH3 had a 43% diameter narrowing of a small ramus intermedius otT the left coronary artery with no significant narrowing of the major coronary arteries. Positron emission tomography of myocardial perfusion before and after intravenous dipyridamole combined with handgrip stress utilizing generator-produced 82Rb provides sensitive and specific diagnosis of reduced coronary Row reserve due to coronary artery disease in humans.

AB - The purpose of this study was to determine the clinical feasibility of diagnosing significant coronary artery disease by positron imaging of myocardial perfusion without a cyclotron, using generator-produced rubidium-82 (82Rb). Fifty patients underwent positron emission tomography of the entire heart using a multislice positron camera and intravenous 82Rb or nitrogen-13 ammonia (13NH3) before and after intravenous dipyridamole combined with handgrip stress. Images were read by two observers blinded as to clinical or arteriographic data. Automated quantitative coronary arteriography was obtained for the arteriographic determination of coronary Row reserve, previously demonstrated to be a single integrated measure of stenosis severity accounting for all its geometric dimensions oflength, absolute diameter, percent narrowing and asymmetry by quantitative analysis of cine films. Significant coronary artery disease was defined as an arteriographicaUy determined coronary flow reserve of less than 3.0 based on all stenosis dimensions. Any single geometric measure of stenosis severity alone was an inadequate reference standard for comparison with perfusion images. Sensitivity of identifying patients with coronary artery disease having an arteriographically determined coronary Row reserve of less than 3.0 was 95% by positron imaging with a specificity of 100%. The single case that was missed, studied with 13NH3 had a 43% diameter narrowing of a small ramus intermedius otT the left coronary artery with no significant narrowing of the major coronary arteries. Positron emission tomography of myocardial perfusion before and after intravenous dipyridamole combined with handgrip stress utilizing generator-produced 82Rb provides sensitive and specific diagnosis of reduced coronary Row reserve due to coronary artery disease in humans.

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Noninvasive assessment of coronary stenoses by myocardial perfusion imaging during pharmacologic coronary vasodilation. VIII. Clinical feasibility of positron cardiac imaging without a cyclotron using generator-produced Rubidium-82

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