Second-Line Myocardial Perfusion Imaging to Detect Obstructive Stenosis: Head-to-Head Comparison of CMR and PET

doi:10.1016/j.jcmg.2022.11.015

Second-Line Myocardial Perfusion Imaging to Detect Obstructive Stenosis: Head-to-Head Comparison of Cardiac Magnetic Resonance (CMR) and PET

JACC Cardiovasc ImagingPublished 8 Feb 2023Diagnostic accuracy study

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Authors' conclusion

In patients with suspected obstructive stenosis at coronary CTA, CMR, and RbPET show similar and moderate sensitivities but high specificities compared with ICA with FFR.

Study context

Population: Patients referred for coronary computed tomography angiography (CTA) with symptoms suggestive of obstructive coronary artery disease (CAD) and suspected stenosis on CTA372 completed CMR, RbPET and invasive coronary angiography (ICA)
Participants: 1,732 patients

Comparison: 3.0-T CMR vs RbPET as second-line myocardial perfusion imaging (MPI), ICA with fractional flow reserve (FFR) as reference
Outcome: Diagnostic performance for obstructive CAD (FFR ≤0.80 or >90% diameter stenosis) vs ICA with FFR

Methodological detailshead-to-head, consecutive patients

Head-to-head
Consecutive patients

Performance

As reported in the abstract

Diagnostic performance vs ICA with FFR

Test or model	Sensitivity	Specificity	Accuracy
CMR	59% (95% CI: 51%-67%)Sensitivity on a scale from 0 to 100 percent	84% (95% CI: 78%-89%)Specificity on a scale from 0 to 100 percent	73%
RbPET	64% (95% CI: 56%-71%)Sensitivity on a scale from 0 to 100 percent	89% (95% CI: 84%-93%)Specificity on a scale from 0 to 100 percent	78%

Sensitivity

CMR59% (95% CI: 51%-67%)

RbPET64% (95% CI: 56%-71%)

Specificity

CMR84% (95% CI: 78%-89%)

RbPET89% (95% CI: 84%-93%)

Accuracy

CMR73%

RbPET78%

RbPET vs CMR: P = 0.21 — sensitivity
RbPET vs CMR: P = 0.08 — specificity
RbPET vs CMR: P = 0.03 — overall accuracy higher with RbPET

Original publication

Second-Line Myocardial Perfusion Imaging to Detect Obstructive Stenosis: Head-to-Head Comparison of CMR and PET. JACC Cardiovasc Imaging. Published 8 February 2023. doi:10.1016/j.jcmg.2022.11.015

Read the original article ↗PubMed

Summarised from the published abstract; every number is checked against it