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Determining Hemodynamically Significant Coronary Artery Disease : Patient-Specific Cutoffs in Quantitative Myocardial Blood Flow Using [15O]H2O PET Imaging
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- Hoek, Roel (författare)
- Vrije Univ Amsterdam, Amsterdam Univ Med Ctr, Dept Cardiol, Amsterdam, Netherlands.
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- van Diemen, Pepijn A. (författare)
- Vrije Univ Amsterdam, Amsterdam Univ Med Ctr, Dept Cardiol, Amsterdam, Netherlands.
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- Raijmakers, Pieter G. (författare)
- Vrije Univ Amsterdam, Amsterdam Univ Med Ctr, Dept Radiol & Nucl Med, Amsterdam, Netherlands.
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- Vrije Univ Amsterdam, Amsterdam Univ Med Ctr, Dept Cardiol, Amsterdam, Netherlands Vrije Univ Amsterdam, Amsterdam Univ Med Ctr, Dept Radiol & Nucl Med, Amsterdam, Netherlands. (creator_code:org_t)
- Society of Nuclear Medicine, 2024
- 2024
- Engelska.
- Ingår i: Journal of Nuclear Medicine. - : Society of Nuclear Medicine. - 0161-5505 .- 1535-5667. ; 65:7, s. 1113-1121
- Tidskriftsartikel (refereegranskat)
Abstract
Ämnesord
Stäng
- Currently, cutoffs of quantitative [15O]H2O PET to detect fractional flow reserve (FFR)-defined coronary artery disease (CAD) were derived from a single cohort that included patients without prior CAD. However, prior CAD, sex, and age can influence myocardial blood flow (MBF). Therefore, the present study determined the influence of prior CAD, sex, and age on optimal cutoffs of hyperemic MBF (hMBF) and coronary flow reserve (CFR) and evaluated whether cutoff optimization enhanced diagnostic performance of quantitative [15O]H2O PET against an FFR reference standard. Methods: Patients with chronic coronary symptoms underwent [15O]H2O PET and invasive coronary angiography with FFR. Optimal cutoffs for patients with and without prior CAD and subpopulations based on sex and age were determined. Results: This multicenter study included 560 patients. Optimal cutoffs were similar for patients with (n = 186) and without prior CAD (hMBF, 2.3 vs. 2.3 mL center dot min-1 center dot g-1; CFR, 2.7 vs. 2.6). Females (n = 190) had higher hMBF cutoffs than males (2.8 vs. 2.3 mL center dot min-1 center dot g-1), whereas CFRs were comparable (2.6 vs. 2.7). However, female sex-specific hMBF cutoff implementation decreased diagnostic accuracy as compared with the cutoff of 2.3 mL center dot min-1 center dot g-1 (72% vs. 82%, P , 0.001). Patients aged more than 70 y (n = 79) had lower hMBF (1.7 mL center dot min-1 center dot g-1) and CFR (2.3) cutoffs than did patients aged 50 y or less, 51-60 y, and 61-70 y (hMBF, 2.3-2.4 mL center dot min-1 center dot g-1; CFR, 2.7). Age-specific cutoffs in patients aged more than 70 y yielded comparable accuracy to the previously established cutoffs (hMBF, 72% vs. 76%, P = 0.664; CFR, 80% vs. 75%, P = 0.289). Conclusion: Patients with and without prior CAD had similar [15O]H2O PET cutoffs for detecting FFR-defined significant CAD. Stratifying patients according to sex and age led to different optimal cutoffs; however, these values did not translate into an increased overall accuracy as compared with previously established thresholds for MBF.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)
Nyckelord
- PET
- fractional flow reserve
- cutoff values
- hyperemic myocardial blood flow
- coronary flow reserve
- coronary artery disease
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- Hoek, Roel
- van Diemen, Pepi ...
- Raijmakers, Piet ...
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- Jukema, Ruurt A.
- Twisk, Jos W. R.
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- Saraste, Antti
- Lubberink, Mark
- Sörensen, Jens
- Knaapen, Paul
- Knuuti, Juhani
- Danad, Ibrahim
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