Comparison of CT-derived Plaque Characteristic Index With Cardiac Magnetic Resonance (CMR) Perfusion for Ischemia Diagnosis in Stable CAD
Authors' conclusion
In our prospective study, CCTA-derived plaque characteristics and MPR derived from CMR performed well in diagnosing lesion-specific myocardial ischemia and were significantly better than stress MBF in stable coronary artery disease.
Study context
- Population
- Patients with suspected or known CAD clinically referred for invasive coronary angiography, October 2020–March 2022
- Participants
- Nighty-two patients141 vessels
- Comparison
- Coronary computed tomography angiography (CCTA)-derived plaque characteristic index vs CMR perfusion-derived stress myocardial blood flow (MBF) and myocardial perfusion reserve (MPR), with invasive FFR as reference
- Outcome
- Diagnostic performance for lesion-specific ischemia (fractional flow reserve ≤0.80)
Methodological detailsprospective, consecutive patients, CCTA, CMR and invasive fractional flow reserve within 2 weeks
- Prospective
- Consecutive patients
- CCTA, CMR and invasive fractional flow reserve within 2 weeks
Performance
As reported in the abstract
Lesion-specific ischemia diagnosis
| Test or model | Sensitivity | Specificity | PPV | NPV | Accuracy |
|---|---|---|---|---|---|
| Stress MBF | 55.3% | 63.1% | 35.6% | 79.3% | 61.0% |
| MPR | 89.5% | 89.3% | 75.6% | 95.8% | 89.4% |
| CCTA-derived plaque characteristic index | 79.0% | 84.5% | 65.2% | 91.6% | 82.3% |
Sensitivity
Stress MBF55.3%
MPR89.5%
CCTA-derived plaque characteristic index79.0%
Specificity
Stress MBF63.1%
MPR89.3%
CCTA-derived plaque characteristic index84.5%
PPV
Stress MBF35.6%
MPR75.6%
CCTA-derived plaque characteristic index65.2%
NPV
Stress MBF79.3%
MPR95.8%
CCTA-derived plaque characteristic index91.6%
Accuracy
Stress MBF61.0%
MPR89.4%
CCTA-derived plaque characteristic index82.3%
Further findings
Plaque and perfusion features, flow-limiting vs nonflow-limiting stenosis
- Plaque length, minimum luminal area, plaque area, percent area stenosis, total atheroma volume, vessel volume, lipid-rich volume, spotty calcium, napkin-ring signs, stress MBF and MPR significantly different between flow-limiting and nonflow-limiting groups
Original publication
Comparison of CT-derived Plaque Characteristic Index With CMR Perfusion for Ischemia Diagnosis in Stable CAD. Circ Cardiovasc Imaging. Published 19 September 2023. doi:10.
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