0054: Validation of stress thallium-201/rest technetium-99m sequential dual isotope high-speed myocardial perfusion imaging against fractional flow reserve for the detection of the extent of ischemia - 12/02/16
, Alex Calizzano ((1)), Estelle Vautrin ((1)), Jean-Louis Quesada ((1)), Alexis Broisat ((4)), Laurent Riou ((4)), Jean-Philippe Baguet ((5)), Jacques Machecourt ((5)), Daniel Fagret ((5)), Catherine Ghezzi ((5)), Gérald Vanzetto ((5))Bienvenue sur EM-consulte, la référence des professionnels de santé.
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Résumé |
Objectives |
The aim of this study was to determine the diagnostic accuracy of stress thallium-201/rest technetium-99m sequential dual-isotope high-speed myocardial perfusion imaging (DI-HS-MPI) against invasively determined fractional flow reserve (FFR) and to establish the correlation between myocardium at risk defined by using the invasive BARI-score and DI-HS-MPI.
Background |
Relatively few studies have compared the diagnostic performance of new Cadmium Zinc Telluride - cameras versus FFR.
Methods |
Fifty-four patients referred for angiography underwent DI-HSMPI. Perfusion was scored visually by summed stress score (SSS) on a patient and coronary territory basis, and ischemic burden was calculated by quantitative segmentation of the extent of ischemia. Significant coronary artery disease (CAD) was defined by the presence of≥90% stenosis/occlusion or fractional flow reserve≤0.80 in vessels>2mm. The relation between FFR and perfusion was determined for each vascular zone. The BARI-score was calculated from the coronary angiograms to quantify the myocardium at risk.
Results |
FFR was measured in 70 of 162 coronary vessels; Vessels FFR measured per patient was 1.3±0.57. Sensitivity, specificity, and diagnostic accuracy of MPI for the detection of significant CAD were 92%, 88%, and 90% by coronary territory and 87%, 93%, and 92%, on a patient basis. The area under the summary receiver-operating characteristic at the patient level was 0.94 (95% CI: 0.88 to 1) and 0.90 (95% CI: 0.83 to 0.97) at the artery and territory levels, respectively. The mean ischemic burden for MPI and BARI-score showed a strong correlation between techniques (r=0.71, P<0.0001).
Conclusions |
Stress thallium-201/rest technetium-99m sequential DI-HSMPI accurately detects functionally significant CAD as defined by using FFR and provides an assessment of ischemic burden in agreement with the invasive BARI-score.
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Vol 8 - N° 1
P. 46-47 - janvier 2016 Retour au numéro
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