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DMBN Web Exclusive: PET vs. SPECT in CAD detection

by Olga Deshchenko, DOTmed News Reporter | June 27, 2011
Dr. Jamshid Maddahi
The PET industry is hoping to get a boost from the approval of new radiopharmaceutical agents in the next few years.

And one company, Lantheus Medical Imaging, Inc, recently shared the results of its phase 2 clinical trial of Flurpiridaz F 18, a novel myocardial perfusion PET agent.

To learn more about the agent, DOTmed News caught up with Dr. Jamshid Maddahi, the study's lead principal investigator. He is also a professor of molecular and medical pharmacology and cardiology at the David Geffen School of Medicine at the University of California, Los Angeles.

Can you provide some background on your involvement and work in cardiology?

Dr. Maddahi: I began my research work in the field of Nuclear Cardiology in 1977. I have been conducting most of my research in two main areas: 1) assessment of myocardial perfusion for noninvasive detection and evaluation of coronary artery disease, and 2) evaluation of myocardial viability in the management of heart failure patients. Our research work in myocardial perfusion assessment evolved from the planar imaging modality to SPECT and then the PET method. We have also evaluated various myocardial perfusion imaging agents; initially thallium-201, then Tc-99m labeled agents and more recently flurpiridaz F 18.

You presented on Phase 2 clinical trial data on flurpiridaz F 18 at ICNC10. What is this PET agent and what potential does it hold?

Dr. Maddahi: Flurpiridaz F 18 is a new myocardial perfusion PET agent that has several advantages as compared to the most commonly used current alternative agent, rubidium-82. It is more practical because it can be produced by existing regional cyclotron facilities and can be used in conjunction with treadmill exercise testing. Also, flurpiridaz F 18 image quality is expected to be superior because of a higher image resolution and myocardial extraction fraction. These properties would potentially translate to improved detection of coronary artery disease and better quantitation of myocardial blood flow.

In the Phase 2 trial, 143 patients from 21 centers underwent rest and stress PET and SPECT myocardial perfusion imaging and were evaluated for safety. Can you share some of the major highlights from the results of this trial?

Dr. Maddahi: Results from this Phase 2 trial show that PET myocardial perfusion imaging with flurpiridaz F 18 demonstrate a strong safety profile and is superior to Tc-99m labeled SPECT imaging with respect to the quality of rest and stress images, certainty of image interpretation, and diagnostic performance as measured by standard Receiver Operating Characteristic (ROC) analysis for detecting coronary artery disease.

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