Sang-Geon Cho1, Soo Jin Lee2, Myung Hwan Na3, Yun Young Choi4, Henry Hee-Seung Bom5. 1. Department of Nuclear Medicine, Chonnam National University Hospital, 42, Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea. mujuk203@hanmail.net. 2. Department of Nuclear Medicine, Hanyang University Medical Center, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 04763, Republic of Korea. 3. Department of Statistics, Chonnam National University, 45, Yongbong-ro, Buk-gu, Kwangju, 61186, Republic of Korea. 4. Department of Nuclear Medicine, Hanyang University Medical Center, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 04763, Republic of Korea. yychoi@hanyang.ac.kr. 5. Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, 322, Seoyang-ro Hwasun-eup, Hwasun-gun, Jeonnam, 58128, Republic of Korea. hsbom@jnu.ac.kr.
Abstract
BACKGROUND: Although absolute quantification of myocardial blood flow (MBF) by positron emission tomography provides additive diagnostic value to visual analysis of perfusion defect, diagnostic accuracy of different MBF parameters remain unclear. METHODS: Clinical studies regarding the diagnostic accuracy of hyperemic MBF (hMBF), myocardial flow reserve (MFR) and/or relative flow reserve (RFR) were searched and systematically reviewed. On a per-vessel basis, pooled measures of the parameters' diagnostic performances were analyzed, regarding significant coronary stenosis defined by fractional flow reserve or diameter stenosis. RESULTS: Ten studies (2,522 arteries from 1,099 patients) were finally included. Pooled sensitivity [95% confidence interval (CI)] was 0.853 (0.821-0.881) for hMBF, 0.755 (0.713-0.794) for MFR, and 0.636 (0.539-0.726) for RFR. Pooled specificity (95% CI) was 0.844 (0.827-0.860) for hMBF, 0.804 (0.784-0.824) for MFR, and 0.897 (0.860-0.926) for RFR. Pooled area under the curve ± standard error was 0.900 ± 0.020 for hMBF, 0.830 ± 0.026 for MFR, and 0.873 ± 0.048 for RFR. CONCLUSIONS: hMBF showed the best sensitivity while RFR showed the best specificity in the diagnosis of significant coronary stenosis. MFR was less sensitive than hMBF and less specific than hMBF and RFR.
BACKGROUND: Although absolute quantification of myocardial blood flow (MBF) by positron emission tomography provides additive diagnostic value to visual analysis of perfusion defect, diagnostic accuracy of different MBF parameters remain unclear. METHODS: Clinical studies regarding the diagnostic accuracy of hyperemic MBF (hMBF), myocardial flow reserve (MFR) and/or relative flow reserve (RFR) were searched and systematically reviewed. On a per-vessel basis, pooled measures of the parameters' diagnostic performances were analyzed, regarding significant coronary stenosis defined by fractional flow reserve or diameter stenosis. RESULTS: Ten studies (2,522 arteries from 1,099 patients) were finally included. Pooled sensitivity [95% confidence interval (CI)] was 0.853 (0.821-0.881) for hMBF, 0.755 (0.713-0.794) for MFR, and 0.636 (0.539-0.726) for RFR. Pooled specificity (95% CI) was 0.844 (0.827-0.860) for hMBF, 0.804 (0.784-0.824) for MFR, and 0.897 (0.860-0.926) for RFR. Pooled area under the curve ± standard error was 0.900 ± 0.020 for hMBF, 0.830 ± 0.026 for MFR, and 0.873 ± 0.048 for RFR. CONCLUSIONS: hMBF showed the best sensitivity while RFR showed the best specificity in the diagnosis of significant coronary stenosis. MFR was less sensitive than hMBF and less specific than hMBF and RFR.
Authors: Wijnand J Stuijfzand; Valtteri Uusitalo; Tanja Kero; Ibrahim Danad; Mischa T Rijnierse; Antti Saraste; Pieter G Raijmakers; Adriaan A Lammertsma; Hans J Harms; Martijn W Heymans; Marc C Huisman; Koen M Marques; Sami A Kajander; Mikko Pietilä; Jens Sörensen; Niels van Royen; Juhani Knuuti; Paul Knaapen Journal: Circ Cardiovasc Imaging Date: 2015-01 Impact factor: 7.792
Authors: Michael Markl; Daniel C Lee; Nicholas Furiasse; Maria Carr; Charles Foucar; Jason Ng; James Carr; Jeffrey J Goldberger Journal: Circ Cardiovasc Imaging Date: 2016-09 Impact factor: 7.792
Authors: Marije E Kamphuis; Henny Kuipers; Jacqueline Verschoor; Johannes C G van Hespen; Marcel J W Greuter; Riemer H J A Slart; Cornelis H Slump Journal: EJNMMI Phys Date: 2022-04-25
Authors: Matthieu Bailly; Frédérique Thibault; Maxime Courtehoux; Gilles Metrard; Denis Angoulvant; Maria Joao Ribeiro Journal: Front Med (Lausanne) Date: 2021-06-04