Relative MBF provided superior diagnostic accuracy over absolute MBF for detecting significant coronary stenosis (AUC 0.925 vs 0.882, P=0.0022; sensitivity 90.7% vs 82.4%, P<0.04).
Observational (n=137)
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Does relative MBF provide better diagnostic accuracy than absolute MBF derived from stress dynamic CT MPI for detecting significant coronary artery stenosis in patients with suspected or known CAD?
Relative myocardial blood flow derived from stress dynamic CT perfusion imaging offers superior diagnostic accuracy over absolute blood flow for detecting significant coronary stenosis.
valor p: p=0.0022
OBJECTIVE: The purpose of this study was to evaluate differences in the diagnostic accuracy of absolute and relative territorial myocardial blood flow (MBF) derived from stress dynamic CT myocardial perfusion imaging (MPI) for the detection of significant coronary artery stenosis. MATERIALS AND METHODS: Dynamic CT MPI and coronary CT angiography (CTA) datasets from a multicenter registry of 137 patients (mean age, 60.9 ± 8.4 years; 88 men) with suspected or known coronary artery disease were retrospectively analyzed. For each coronary territory, absolute MBF and the MBF relative to remote myocardium (MBF ratio) were calculated. Coronary CTA datasets were visually assessed for significant stenosis (≥ 50% luminal narrowing) in consensus by two observers. RESULTS: Significant stenosis was detected in 137 of 411 (33.3%) vessels. Mean absolute MBF and MBF ratio were statistically significantly lower in territories supplied by arteries with stenosis (80.7 ± 33.7 vs 140.0 ± 38.4 mL/100 mL/min and 0.52 vs 0.89, respectively; both p < 0.0001). ROC analysis showed better discrimination by MBF ratio than by absolute MBF (AUC, 0.925 vs 0.882; p = 0.0022) and increased sensitivity (90.7% vs 82.4%; p < 0.04) and specificity (93.1% vs 80.5%; p < 0.03) for MBF ratio and absolute MBF cutoff values of 0.71 or less and 103 mL/100 mL/min or less, respectively. CONCLUSION: In stress dynamic CT MPI, relative MBF provides superior diagnostic accuracy compared with absolute territorial MBF values for coronary CTA-detected significant coronary artery stenosis.
Wichmann et al. (Tue,) conducted a observational in Suspected or known coronary artery disease (n=137). Relative myocardial blood flow (MBF ratio) vs. Absolute myocardial blood flow was evaluated on Discrimination of significant coronary artery stenosis (≥ 50% luminal narrowing) (p=0.0022). Relative MBF provided superior diagnostic accuracy over absolute MBF for detecting significant coronary stenosis (AUC 0.925 vs 0.882, P=0.0022; sensitivity 90.7% vs 82.4%, P<0.04).
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