Impact of Absolute Myocardial Blood Flow Quantification on the Diagnostic Performance of PET-Based Perfusion Scans Using 82 Rubidium
Authors' conclusion
The inclusion of quantitative measurements to a RbPET read increases in the identification of obstructive CAD.
Study context
- Population
- Patients undergoing RbPET and invasive coronary angiography with FFR for suspected obstructive coronary artery disease (CAD)170 (42.5%) obstructive CAD
- Participants
- 400 patients
- Comparison
- RbPET reading algorithms: SSS alone vs added quantitative myocardial blood flow (MBF) and MBF reserve
- Outcome
- Diagnostic accuracy for hemodynamically obstructive CAD (>90% diameter stenosis or FFR ≤0.80)
Methodological detailsprospective
- Prospective
Performance
As reported in the abstract
Hemodynamically obstructive CAD
| Test or model | Sensitivity | Specificity |
|---|---|---|
| SSS | 57% | 93% |
| Hyperemic MBF | 61% | 85% |
| SSS + MBF + MBF reserve | 77% | 74% |
Sensitivity
SSS57%
Hyperemic MBF61%
SSS + MBF + MBF reserve77%
Specificity
SSS93%
Hyperemic MBF85%
SSS + MBF + MBF reserve74%
- Hyperemic MBF vs SSS: P = 0.57
- Hyperemic MBF vs SSS: P = 0.008
- SSS + MBF + MBF reserve vs SSS: P < 0.001 — 0.78 versus 0.85
- SSS + MBF + MBF reserve vs SSS: P < 0.001 — P<0.001 for both comparisons
Further findings
Anatomically severe CAD (>70% diameter stenosis by QCA), sensitivity analysis
- All measures independently yielded discrimination ≥0.90; added quantification increased sensitivity and lowered specificity
Original publication
Impact of Absolute Myocardial Blood Flow Quantification on the Diagnostic Performance of PET-Based Perfusion Scans Using 82 Rubidium. Circ Cardiovasc Imaging. Published 16 January 2024. doi:10.
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