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The diagnostic performance of SPECT-MPI to predict functional significant coronary artery disease by fractional flow reserve derived from CCTA (FFRCT): sub-analysis from ACCURACY and VCT001 studies

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Abstract

Although single photon emission computed tomography-myocardial perfusion image (SPECT-MPI) and fractional flow reserve (FFR) derived from coronary computed tomographic angiography (CCTA) (FFRCT) have permitted functional assessment of coronary artery disease (CAD), the concordance between these modalities has not been well described. The aim of this study is to compare SPECT-MPI and anatomical stenosis by CCTA and invasive coronary angiography to FFRCT for assessing functional significance of CAD. We identified 62 patients with suspected CAD who underwent ≥64 slice coronary CTA and SPECT-MPI within 3 months. FFRCT was analyzed from CCTA data using the computational fluid dynamic techniques. The association between SPECT-MPI ischemia and FFRCT (≤0.80) was evaluated. Out of 62 patients, 186 vessels were evaluated. On a per-vessel analysis, accuracy, sensitivity and specificity of SPECT-MPI to predict FFRCT ≤ 0.80 was 74.2, 45.0 and 77.7%, respectively. The area under the curve (AUC) by receiver-operating characteristic curve analysis for SPECT-MPI demonstrated a modest performance for predicting FFRCT ≤ 0.80 (AUC 0.56). Among patients with suspected CAD who were assessed by non-invasive functional modalities, SPECT-MPI showed modest concordance with FFRCT.

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Acknowledgements

Dr. Campbell Rogers and Mr. Souma Gupta are full time employees of HeartFlow, with salary and equity from HeartFlow.

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Authors and Affiliations

  1. Los Angeles BioMedical Research Institute at Harbor UCLA Medical Center, Torrance, CA, USA

    Rine Nakanishi, Kazuhiro Osawa, Indre Ceponiene, Michael Kim, Negin Nezarat, Sina Rahmani, Dong Li, Christopher Dailing & Matthew J. Budoff

  2. ThedaCare Cardiovascular Care, Appleton, WI, USA

    Glenn Huth

  3. Cardiology Associates, Mobile, AL, USA

    Jason Cole

  4. HeartFlow Inc., Redwood, CA, USA

    Souma Gupta & Campbell Rogers

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  1. Rine Nakanishi
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  2. Kazuhiro Osawa
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Correspondence to Matthew J. Budoff.

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Unrestricted money as grant support to institution to do independent research from HeartFlow. The other authors have no conflict of interest.

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Nakanishi, R., Osawa, K., Ceponiene, I. et al. The diagnostic performance of SPECT-MPI to predict functional significant coronary artery disease by fractional flow reserve derived from CCTA (FFRCT): sub-analysis from ACCURACY and VCT001 studies. Int J Cardiovasc Imaging 33, 2067–2072 (2017). https://doi.org/10.1007/s10554-017-1207-y

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