Clinical Usefulness of Coronary Flow Reserve Ratio for the Detection of Significant Coronary Artery Disease on 13N-Ammonia Positron Emission Tomography

Naoto Kawaguchi, Hideki Okayama, Go Kawamura, Tatsuya Shigematsu, Tatsunori Takahashi, Yoshitaka Kawada, Go Hiasa, Tadakatsu Yamada, Hiroshi Matsuoka, Yukio Kazatani, Masao Miyagawa, Teruhito Mochizuki
2018 Circulation Journal  
This study aimed to evaluate the diagnostic performance of coronary flow reserve (CFR), hyperemic myocardial blood flow (hMBF), and CFR ratio for detecting significant coronary artery disease (CAD) on 13 N-ammonia positron emission tomography (PET). Methods and Results: We analyzed 63 patients (mean age, 71±9 years; 43 males) with suspected CAD who underwent both pharmacological stress/rest 13 N-ammonia PET and coronary angiography. CFR and hMBF for PET were calculated automatically using
more » ... tative PET software, and the CFR ratio was defined as the ratio of per-vessel CFR to maximum CFR in a standard 17-segment model. We compared the diagnostic performance among the 3 quantitative values. In the per-vessel analysis, 55 vessels were diagnosed as significant CAD (≥70% stenosis and/or fraction flow reserve ≤0.8). CFR, hMBF, and CFR ratio of significant CAD were significantly lower than for non-significant CAD (1.85±0.69 vs. 2.38±0.69; P<0.01, 1.67±0.54 vs. 2.19±0.52 mL · min −1 · g −1 ; P<0.01, and 0.66±0.15 vs. 0.82±0.09; P<0.01, respectively). In the receiver-operating characteristic curve analysis, CFR, hMBF, and CFR ratio had areas under the curve of 0.71, 0.75, and 0.85 respectively, and the CFR ratio was significantly higher than CFR and hMBF (P<0.05). The sensitivity, specificity, and accuracy of the CFR ratio with an optimal cutoff value of 0.75 were 75%, 85%, and 82%, respectively. Conclusions: Clinically, the CFR ratio in 13 N-ammonia PET was more effective in detecting significant CAD.
doi:10.1253/circj.cj-17-0745 pmid:28954967 fatcat:zkqjrbyct5cippr4bndvkelfqi