AIMS To examine whether test utilization and prevalence of ischemia with positron emission tomography (PET) myocardial perfusion imaging (MPI) follow the previously described trends with single photon computed tomography (SPECT). METHODS AND RESULTS MPI studies performed between January 2003 and December 2017 were identified. Number of PET and SPECT MPI studies performed per year was determined. Trends in the proportion of studies showing any ischaemia (>0%) with both modalities were compared before and after adjusting for baseline differences in patient characteristics using propensity scores. Interaction between imaging modality and year of testing was examined using modified Poisson regression. A total of 156 244 MPI studies were performed (30% PET and 70% SPECT). Between 2003 and 2017, the number of PET studies increased from 18 to 61 studies/1000 patient encounters, while SPECT volumes declined from 169 to 34/1000 patient encounters (P < 0.001 for within-group comparisons). The prevalence of any ischaemia in SPECT-tested patients declined from 53.9% to 28.3% between 2003 and 2017, whereas ischaemia prevalence in PET-tested patients declined from 57.2% to 38.2% (P < 0.001 for within-modality comparisons), with more PET studies showing ischaemia compared to SPECT [relative risk (RR) 1.44, 95% confidence interval (CI) 1.42-1.47; P < 0.001]. After propensity score matching of 26 066 patients tested with SPECT with 26 066 patients tested with PET, the between-modality difference in ischaemia prevalence was significantly attenuated, with a slightly higher overall likelihood of detecting ischaemia with PET compared to SPECT (RR 1.08, 95% CI 1.05-1.11; P < 0.001). CONCLUSIONS Utilization of PET MPI at a large-volume referral centre increased significantly between 2003 and 2017. Despite a significant decrease in the prevalence of ischaemia with SPECT and PET during the same period, the decline was less with PET, perhaps related to baseline risk of tested patients.

中文翻译：

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正电子发射断层扫描心肌灌注显像在测试利用率和局部缺血患病率上的时间趋势。

目的为了检查正电子发射断层扫描（PET）心肌灌注成像（MPI）的测试利用率和局部缺血患病率是否遵循上述单光子计算机断层扫描（SPECT）趋势。方法和结果确定了2003年1月至2017年12月进行的MPI研究。确定每年进行的PET和SPECT MPI研究的数量。在使用倾向性得分调整患者特征的基线差异之前和之后，比较了两种方式均显示出任何局部缺血（> 0％）的研究比例趋势。使用改进的泊松回归分析检查成像方式与测试年份之间的相互作用。总共进行了156 244个MPI研究（30％PET和70％SPECT）。在2003年至2017年之间，PET研究的数量从每1000例患者的18项研究增加到61项研究，而SPECT的数量从169例减少至34/1000例患者（组内比较，P <0.001）。在2003年至2017年之间，经SPECT测试的患者中任何缺血的患病率从53.9％下降至28.3％，而经PET检测的患者中的局部缺血患病率从57.2％下降至38.2％（模式内比较的P <0.001），并且更多与SPECT相比，PET研究显示局部缺血[相对风险（RR）1.44，95％置信区间（CI）1.42-1.47；P <0.001]。在使用SPECT测试的26 066名患者和使用PET测试的26 066名患者的倾向评分匹配之后，缺血性患病率之间的模态差异显着减弱，与SPECT相比，用PET检测局部缺血的总体可能性略高（RR 1.08，95％CI 1.05-1.11； P <0.001）。结论2003年至2017年间，大批量转诊中心对PET MPI的使用显着增加。尽管同期SPECT和PET缺血性患病率显着下降，但PET的下降幅度较小，这可能与基线风险有关。测试的患者。