Author + information
- Rine Nakanishi,
- Kazuhiro Osawa,
- Indre Ceponiene,
- Glenn Huth,
- Jason Cole,
- Michael Kim,
- Negin Nezarat,
- Sina Rahmani,
- Dong Li,
- Christopher Dailing and
- Matthew Budoff
Background: 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 computed tomographic angiography (CCTA) and invasive coronary angiography (ICA) to FFRCT for assessing functional significance of CAD.
Methods: We identified 62 patients with suspected CAD who underwent ≥64 slice coronary CTA, SPECT-MPI and invasive coronary angiography (ICA) within 3 months. The association between CCTA stenosis (≥50%), ICA stenosis (≥50%), SPECT-MPI ischemia and FFRCT (≤0.80) was evaluated.
Results: 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. Those of CCTA and ICA stenosis were comparable, with 88.7%, 80% and 91.5% for CCTA and 85.5%, 53.3% and 95.7% for ICA, respectively. The area under the curves (AUC) by receiver-operating characteristic curve analysis for SPECT-MPI demonstrated a modest performance for predicting FFRCT≤0.80 (AUC 0.56), and inferior compared to that for CTA stenosis (AUC 0.79, p<0.001) and ICA stenosis (AUC 0.75, p<0.001). CTA and ICA stenosis demonstrated comparable predictive value for FFRCT≤0.80 (p=0.34).
Conclusions: Among patients with suspected CAD who were assessed by non-invasive functional modalities, SPECT-MPI showed modest concordance with FFRCT. Anatomical stenosis by CCTA and ICA showed greater concordance with FFRCT compared to SPECT-MPI.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Non Invasive Imaging: Expanding Clinical Applications
Abstract Category: 27. Non Invasive Imaging: CT/Multimodality, Angiography, and Non-CT Angiography
Presentation Number: 1161-234
- 2017 American College of Cardiology Foundation