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Diagnostic Accuracy

Superior Diagnostic Accuracy

Quantitative PET perfusion images show the entire range of absolute flows and coronary flow reserves of each artery down to small branches with single or multiple stenosis, diffuse disease, and/or myocardial steal indicating collateralization. PET imaging has become integral to and inseparable from management of CAD—integrated diagnosis, treatment, and procedural guide. 3-4

Coronary flow reserve is a reproducible, reliable and accurate method across the spectrum of coronary artery disease. The following image demonstrates reproducibility and accuracy.

Robust Literature

  • > 250 Papers
  • ~ 15,000 Patients
  • > 25 Years 8

Test-Retest Variability of Common Cardiovascular Measurements

Test-Retest MeasurementCoefficient of Variation
PET flow cc/min/gm14%
Anglogram % DS17%
LDL Cholesterol9.5%
ECHO EF15%
SPECT EF17%
SPECT SSS29%
C-reactive protein4%

Graded absolute flow and coronary flow across spectrum of disease (N = 14,962)

PopulationaRest flow
(cc/min/g)
Stress flow
(cc/min/g)
CFR
Normal controls3,4840.82 ± 0.062.89 ± 1.073.55 ± 1.36
Risk factors only3,5920.85 ± 0.082.25 ± 1.072.80 ± 1.39
Established coronary artery disease1,5500.83 ± 0.101.71 ± 0.712.02 ± 0.70
Mixed (risk factors and/or known coronary artery disease)4,7650.97 ± 0.101.86 ± 0.581.93 ± 0.48
Cardiomyopathy5940.73 ± 0.071.47 ± 0.562.02 ± 0.67
Hypertrophic cardiomyopathy3450.90 ± 0.101.57 ± 0.331.84 ± 0.36
Syndrome X3481.06 ± 0.112.65 ± 1.312.54 ± 1.31
After cardiac transplant1841.14 ± 0.182.44 ± 1.342.29 ± 0.86
N = 14,962 from unique publications. N-13 Ammonia = 5,541; 0-15 water = 3,161;82Rb = 6175.
Gould et a. JACC. 62 (18) 1639-1653

3. Gould KL. Assessing progression or regression of CAD: the role of perfusion imaging. Journal of Nuclear Cardiology. 2005 Nov 1;12(6):625-38.

4. Gould KL. Cardiac positron emission tomography. In: Willerson JT, Cohn JN, Wellens HJJ, Holmes DR, editors. Cardiovascular Medicine. 3rd edition. London, United Kingdom: Springer, 2007:855– 69.

8. Gould et. al JACC Cardiovascular Imaging. 62(18), 1639-53.