Coronary disease & ACSDiagnostic or prognostic study
Flurpiridaz F-18 Positron Emission Tomography (PET) Myocardial Perfusion Imaging in Patients With Suspected Coronary Artery Disease
- Diagnostic accuracy study
- phase 3
- prospective
- multicentre
- blinded readers
Authors' conclusion
This second flurpiridaz PET myocardial perfusion imaging trial shows that flurpiridaz has utility as a new tracer for CAD detection, specifically in women and obese patients.
Study context
- Population
- Patients with suspected coronary artery disease (CAD) undergoing invasive coronary angiography (ICA), 48 sites in the US, Canada and Europe578 evaluable
- Participants
- 730 patients
- Comparison
- Flurpiridaz PET vs Tc-99m single photon emission computed tomography (SPECT) MPI for CAD detection
- Outcome
- Sensitivity and specificity of flurpiridaz PET for CAD (≥50% stenosis by quantitative ICA) vs prespecified threshold
Performance
As reported in the abstract
Diagnostic performance for CAD
| Test or model | Sensitivity | Specificity |
|---|---|---|
| Flurpiridaz PET | 80.3% | 63.8% |
| SPECT | 68.7% | 61.7% |
- Flurpiridaz PET vs SPECT: P = 0.0003 — higher with PET
- Flurpiridaz PET vs SPECT: P = 0.0004 — noninferior
Further findings
| Outcome | Flurpiridaz PET | SPECT | P value |
|---|---|---|---|
| AUC (ROC), overall population | P < 0.001 | ||
| AUC | 0.80 | 0.68 |
AUC (ROC), women and obese patients (subgroups)
- PET AUC higher than SPECT in women and obese patients
- P < 0.001
Perfusion defect size/severity, image quality, diagnostic certainty, radiation exposure
- Flurpiridaz PET superior to SPECT
- P < 0.001
Original publication
Flurpiridaz F-18 PET Myocardial Perfusion Imaging in Patients With Suspected Coronary Artery Disease. J Am Coll Cardiol. Published 17 October 2023. doi:10.1016/j.jacc.2023.08.016
Summarised from the published abstract; every number is checked against it