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Comparison of diagnostic accuracy of PET-derived myocardial blood flow parameters: A meta-analysis

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Journal of Nuclear Cardiology Aims and scope

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.

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Abbreviations

PET:

Positron emission tomography

CAD:

Coronary artery disease

MBF:

Myocardial blood flow

hMBF:

Hyperemic myocardial blood flow

RFR:

Relative flow reserve

SPECT:

Single-photon emission computed tomography

DS:

Diameter stenosis

Ado:

Adenosine

Reg:

Regadenoson

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Disclosure

Henry Hee-Seung Bom receives research fund from the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF2016R1D1A3B01006631). Drs. Sang-Geon Cho, Soo Jin Lee, Myung Hwan Na, and Yun Young Choi declare no conflicts of interests.

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Author notes

  1. Sang-Geon Cho and Soo Jin Lee have equally contributed to this work.

Authors and Affiliations

  1. Department of Nuclear Medicine, Chonnam National University Hospital, 42, Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea

    Sang-Geon Cho MD, PhD

  2. Department of Nuclear Medicine, Hanyang University Medical Center, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 04763, Republic of Korea

    Soo Jin Lee MD, PhD & Yun Young Choi MD, PhD

  3. Department of Statistics, Chonnam National University, 45, Yongbong-ro, Buk-gu, Kwangju, 61186, Republic of Korea

    Myung Hwan Na PhD

  4. Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, 322, Seoyang-ro Hwasun-eup, Hwasun-gun, Jeonnam, 58128, Republic of Korea

    Henry Hee-Seung Bom MD, PhD

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  1. Sang-Geon Cho MD, PhD
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Corresponding authors

Correspondence to Sang-Geon Cho MD, PhD, Yun Young Choi MD, PhD or Henry Hee-Seung Bom MD, PhD.

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Funding

This study was supported by a Grant (NRF-2016R1D1A3B01006631) of the Basic Science Research Program through the National Research Foundation (NRF) funded by the Ministry of Education, Republic of Korea.

All editorial decisions for this article, including selection of reviewers and the final decision, were made by guest editor Henry Gewirtz, MD.

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Cho, SG., Lee, S.J., Na, M.H. et al. Comparison of diagnostic accuracy of PET-derived myocardial blood flow parameters: A meta-analysis. J. Nucl. Cardiol. 27, 1955–1966 (2020). https://doi.org/10.1007/s12350-018-01476-z

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  • DOI: https://doi.org/10.1007/s12350-018-01476-z

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