Rb PET and [O]HO PET are both validated tracers for myocardical perfusion imaging but have not previously been compared clinically. During our site’s transition from Rb to [O]HO PET, we performed a head-to-head comparison in a mixed population with suspected ischemic heart disease. A total of 37 patients referred for perfusion imaging due to suspicion of coronary stenosis were examined with both Rb and [O]HO PET on the same day in rest and during adenosine-induced stress. The exams were rated by two blinded readers as normal, regional ischemia, globally reduced myocardial perfusion, or myocardial scarring. For [O]HO PET, regional ischemia was defined as two neighboring segments with average stress perfusion ≤ 2.3 mL/(min·g). Further, we evaluated a total perfusion deficit (TPD) of ≥ 10% as a more conservative marker of ischemia. [O]HO PET identified more patients with regional ischemia: 17(46%) vs 9(24%), agreement: 59% corresponding to a Cohen’s kappa of .31 [95%CI .08-.53], ( < .001). Using the more conservative TPD ≥ 10%, the agreement increased to 86% corresponding to a kappa of .62 [95%CI .33-.92], ( = .001). For the subgroup of patients with no known heart disease ( = 18), the agreement was 94%. Interrater agreement was 95% corresponding to a kappa of .89 [95%CI .74-1.00] ( < .001). In clinical transition from Rb to [O]HO PET, it is important to take into account the higher frequency of patients with regional ischemia detected by [O]HO PET. ▪

中文翻译：

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82Rb 和 [15O]H2O 心肌灌注 PET 成像：前瞻性头对头比较

Rb PET 和 [O]HO PET 都是经过验证的心肌灌注成像示踪剂，但之前尚未进行过临床比较。在我们的站点从 Rb 过渡到 [O]HO PET 期间，我们对疑似缺血性心脏病的混合人群进行了头对头比较。共有 37 名因怀疑冠状动脉狭窄而转诊进行灌注成像的患者在同一天在休息和腺苷诱导应激期间使用 Rb 和 [O]HO PET 检查。两名盲人检查者将检查结果评定为正常、局部缺血、整体心肌灌注减少或心肌疤痕。对于[O]H2O PET，局部缺血定义为平均应力灌注≤2.3 mL/(min·g)的两个相邻节段。此外，我们评估总灌注不足 (TPD) ≥ 10% 作为更保守的缺血标志。[O]HO PET 识别出更多患有局部缺血的患者：17 例（46%） vs 9 例（24%），一致性：59% 对应于 Cohen's kappa 0.31 [95%CI 0.08-0.53]，（ < . 001）。使用更保守的 TPD ≥ 10%，一致性增加到 86%，对应于 0.62 的 kappa [95%CI .33-.92]，( = .001)。对于没有已知心脏病的患者亚组 (= 18)，一致性为 94%。评估者间一致性为 95%，对应的 kappa 为 0.89 [95%CI .74-1.00] (< .001)。在从 Rb 到 [O]HO PET 的临床过渡中，重要的是要考虑到 [O]HO PET 检测到的局部缺血患者的频率较高。▪