Coronary Artery Stenosis Evaluation by Angiography-Derived Fractional Flow Reserve (FFR): Validation by Positron Emission Tomography and Invasive Thermodilution
Authors' conclusion
With 82Rb-PET as reference modality, the wire-free QFR solution showed similar diagnostic accuracy as invasive FFR in evaluation of intermediate coronary stenosis.
Study context
- Population
- Symptomatic patients with suspected obstructive CAD on coronary CT angiography (≥50% diameter stenosis in ≥1 vessel), intermediate (30%-90%) stenoses
- Participants
- 250 patients · 320 vessels
- Comparison
- QFR vs invasive FFR, with 82Rb-PET MPI as reference standard
- Outcome
- Ability to identify reduced myocardial blood flow (<2 mL/g/min) during vasodilation and/or relative perfusion abnormalities (summed stress score ≥4 in ≥2 adjacent segments) on 82Rb-PET
Methodological detailsprospective, observational
- Prospective
- Observational
Performance
As reported in the abstract
Diagnostic accuracy vs 82Rb-PET
| Test or model | Per-patient accuracy | Per-vessel accuracy |
|---|---|---|
| QFR | 73% (95% CI: 67%-79%) | 70% (95% CI: 64%-75%) |
| FFR | 71% (95% CI: 64%-78%) | 68% (95% CI: 62%-73%) |
Per-patient accuracy
QFR73% (95% CI: 67%-79%)
FFR71% (95% CI: 64%-78%)
Per-vessel accuracy
QFR70% (95% CI: 64%-75%)
FFR68% (95% CI: 62%-73%)
Further findings
| Outcome | QFR | FFR |
|---|---|---|
| 82Rb-PET stress myocardial blood flow per 0.10 increase in index | +0.08 (95% CI 0.02–0.14) mL/g/min | +0.14 (95% CI 0.07–0.21) mL/g/min |
| Per-vessel feasibility · intention-to-diagnose analysis | 84% (95% CI 80%–88%) | 88% (95% CI 85%–92%) |
Original publication
Coronary Artery Stenosis Evaluation by Angiography-Derived FFR: Validation by Positron Emission Tomography and Invasive Thermodilution. JACC Cardiovasc Imaging. Published 12 April 2023. doi:10.
Summarised from the published abstract; every number is checked against it