Michael O. Barry MD, Abstract Co-Author: Nothing to Disclose

Joseph A. Craft MD, Abstract Co-Author: Nothing to Disclose

Pilar Herrero MS, Abstract Co-Author: Nothing to Disclose

Kyongtae Tyler Bae MD, PhD, Abstract Co-Author: Patent agreement, Tyco Healthcare (Mallinckrodt Inc), St Louis, MO Patent agreement, Bayer AG (MedRad, Inc), Pittsburgh, PA Medical Advisory Board, Bracco Group, Milan, Italy Research Consultant, Otsuka Pharmaceutical Co, Ltd, Rockville, MD

Robert J. Gropler MD, Abstract Co-Author: Advisory Board, Bracco Group Research Consultant, Bristol-Myers Squibb Company Speakers Bureau, Bristol-Myers Squibb Company Research grant, Bristol-Myers Squibb Company Research grant, General Electric Company (Amersham plc)

Pamela Karen Woodard MD, Presenter: Speakers Bureau, General Electric Company Research grant, General Electric Company Consultant, Tyco Healthcare (Mallinckrodt Inc) Research support, Siemens AG

To assess the potential of PET and/or CT to provide a noninvasive means of distinguishing between ischemic (ICM) and non-ischemic cardiomyopathy (NICM).

Patients with LV ejection fraction 11C-acetate to measure global and regional variability in myocardial blood flow (MBF) and oxygen consumption (MVO2); and a prospectively EKG-gated non-contrast CT scan to establish a coronary artery calcium (CAC) score, and a retrospectively EKG-gated CT coronary angiogram (CTCA) (Sensation 64, Siemens) to assess extent and severity of coronary artery disease (CAD).

Forty patients (ICM=20, NICM=20) completed the study. Logistical regression was used to measure the strength of association between the imaging measures and the presence of an ICM. Of the PET derived variables, regional variability in MBF, had the strongest association (r2=0.30). While CAC scores were significantly different between ICM and NICM, there was considerable overlap in the values, and therefore the discriminatory ability was weak. CTCA defined CAD extent proved to be the best discriminator (r2=0.71), with a sensitivity and specificity of 100% and 90%, respectively. Multivariable logistic regression model was fit using PET regional variability in MBF and CTCA defined CAD extent. The combined fit improved slightly over CTCA defined CAD extent alone (r2 of 0.86 vs. 0.71, p=0.09).

CTCA accurately discriminates ICM from NICM when compared to the reference standard, CC. The combination of CTCA/PET as a tool to differentiate ICM from NICM still is promising, but needs to be studied in a larger scale, prospective manner.

CTCA’s widespread availability, quick acquisition speed, and minimal complication risks make it viable alternative to CC in differentiating ICM from NICM.

Barry, M, Craft, J, Herrero, P, Bae, K, Gropler, R, Woodard, P, Use of PET and CT to Discriminate between Ischemic and Non-ischemic Cardiomyopathy.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5008193.html