Absolute myocardial blood flows derived by dynamic CZT scan vs invasive fractional flow reserve: Correlation and accuracy

Konstantin V. Zavadovsky, Andrew V. Mochula, Alla A. Boshchenko, Alexander V. Vrublevsky, Andrew E. Baev, Alexander L. Krylov, Marina O. Gulya, Evgeny A. Nesterov, Riccardo Liga, Alessia Gimelli

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16 Citations (Scopus)

Abstract

Purpose: To define the diagnostic power of absolute myocardial blood flow (MBF) evaluation on dynamic CZT imaging in intermediate risk patients in comparison with invasive coronary angiography (ICA) and fractional flow reserve (FFR). Methods: Twenty-three stable CAD patients underwent one-day dynamic rest-stress 99mTc-Sestamibi myocardial perfusion imaging by CZT camera. Stress and rest MBF values were calculated semi-automatically using a net retention model by Leppo. Coronary flow reserve (CFR) and flow difference (FD) [MBF stress − MBF rest] were also estimated. A total of 28 vessels were functionally quantified with FFR: 19 (68%) vessels with a stenosis ≥ 70% and 9 (32%) with < 70% stenotic lesions. Results: The mean global MBFs at rest and during stress were 0.36 (IQR 0.33-0.54) mL/min/g and 0.67 (IQR 0.55-0.81) mL/min/g, respectively, with an average CFR of 1.80 (IQR 1.35-2.24). Moderate correlations between stenosis severity and FFR (r = 0.45; P =.01), stress MBF (r = −0.46; P =.01) and FD (r = −0.37; P =.04) were detected. FFR abnormalities were best predicted by absolute stress MBF, CFR and FD with values of ≤ 0.54 mL/min/g (sensitivity 61.5%; specificity 93.3%), ≤ 1.48 (sensitivity 69.2%; specificity 93.3%) and ≤ 0.18 mL/min/g (sensitivity 69.2%; specificity 100%), respectively. Conclusions: The values of stress MBF, CFR and FD obtained through dynamic CZT acquisitions compare well with invasive FFR. The clinical use of dynamic acquisition of myocardial perfusion imaging by CZT may help cardiologist in the detection of hemodynamically significant CAD.

Original languageEnglish
JournalJournal of Nuclear Cardiology
DOIs
Publication statusPublished - 1 Jan 2019

Keywords

  • Absolute myocardial blood flow
  • coronary flow reserve
  • CZT camera
  • fractional flow reserve

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Zavadovsky, K. V., Mochula, A. V., Boshchenko, A. A., Vrublevsky, A. V., Baev, A. E., Krylov, A. L., Gulya, M. O., Nesterov, E. A., Liga, R., & Gimelli, A. (2019). Absolute myocardial blood flows derived by dynamic CZT scan vs invasive fractional flow reserve: Correlation and accuracy. Journal of Nuclear Cardiology. https://doi.org/10.1007/s12350-019-01678-z