Imperial College London
Alternate

Emeritus ProfessorRichardUnderwood

Faculty of Medicine, National Heart & Lung Institute

Emeritus Professor of Cardiac Imaging
 
 
 
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Contact

 

+44 (0)20 7351 8811srunderwood

 
 
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Location

 

2.30Britten WingRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{van:2020:10.1016/j.jcmg.2020.02.012,
author = {van, Diemen PA and Driessen, RS and Kooistra, RA and Stuijfzand, WJ and Raijmakers, PG and Boellaard, R and Schumacher, SP and Bom, MJ and Everaars, H and de, Winter RW and van, de Ven PM and Reiber, JH and Min, JK and Leipsic, JA and Knuuti, J and Underwood, RS and van, Rossum AC and Danad, I and Knaapen, P},
doi = {10.1016/j.jcmg.2020.02.012},
journal = {JACC Cardiovasc Imaging},
pages = {1976--1985},
title = {Comparison Between the Performance of Quantitative Flow Ratio and Perfusion Imaging for Diagnosing Myocardial Ischemia.},
url = {http://dx.doi.org/10.1016/j.jcmg.2020.02.012},
volume = {13},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - OBJECTIVES: This study compared the performance of the quantitative flow ratio (QFR) with single-photon emission computed tomography (SPECT) and positron emission tomography (PET) myocardial perfusion imaging (MPI) for the diagnosis of fractional flow reserve (FFR)-defined coronary artery disease (CAD). BACKGROUND: QFR estimates FFR solely based on cine contrast images acquired during invasive coronary angiography (ICA). Head-to-head studies comparing QFR with noninvasive MPI are lacking. METHODS: A total of 208 (624 vessels) patients underwent technetium-99m tetrofosmin SPECT and [15O]H2O PET imaging before ICA in conjunction with FFR measurements. ICA was obtained without using a dedicated QFR acquisition protocol, and QFR computation was attempted in all vessels interrogated by FFR (552 vessels). RESULTS: QFR computation succeeded in 286 (52%) vessels. QFR correlated well with invasive FFR overall (R = 0.79; p < 0.001) and in the subset of vessels with an intermediate (30% to 90%) diameter stenosis (R = 0.76; p < 0.001). Overall, per-vessel analysis demonstrated QFR to exhibit a superior sensitivity (70%) in comparison with SPECT (29%; p < 0.001), whereas it was similar to PET (75%; p = 1.000). Specificity of QFR (93%) was higher than PET (79%; p < 0.001) and not different from SPECT (96%; p = 1.000). As such, the accuracy of QFR (88%) was superior to both SPECT (82%; p = 0.010) and PET (78%; p = 0.004). Lastly, the area under the receiver operating characteristics curve of QFR, in the overall sample (0.94) and among vessels with an intermediate lesion (0.90) was higher than SPECT (0.63 and 0.61; p < 0.001 for both) and PET (0.82; p < 0.001 and 0.77; p = 0.002), respectively. CONCLUSIONS: In this head-to-head comparative study, QFR exhibited a higher diagnostic value for detecting FFR-defined significant CAD compared
AU  - van,Diemen PA
AU  - Driessen,RS
AU  - Kooistra,RA
AU  - Stuijfzand,WJ
AU  - Raijmakers,PG
AU  - Boellaard,R
AU  - Schumacher,SP
AU  - Bom,MJ
AU  - Everaars,H
AU  - de,Winter RW
AU  - van,de Ven PM
AU  - Reiber,JH
AU  - Min,JK
AU  - Leipsic,JA
AU  - Knuuti,J
AU  - Underwood,RS
AU  - van,Rossum AC
AU  - Danad,I
AU  - Knaapen,P
DO  - 10.1016/j.jcmg.2020.02.012
EP  - 1985
PY  - 2020///
SP  - 1976
TI  - Comparison Between the Performance of Quantitative Flow Ratio and Perfusion Imaging for Diagnosing Myocardial Ischemia.
T2  - JACC Cardiovasc Imaging
UR  - http://dx.doi.org/10.1016/j.jcmg.2020.02.012
UR  - https://www.ncbi.nlm.nih.gov/pubmed/32305469
VL  - 13
ER  -
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