QFR vs. perfusion imaging to predict abnormal FFR in patients with prior coronary artery disease

Abstract Background In patients with suspected obstructive coronary artery disease (CAD) and a high pre-test probability, myocardial perfusion imaging (MPI) or referral for invasive angiography (ICA) are viable diagnostic strategies. The present study compared the performance of quantitative flow ratio (QFR) MPI by single-photon emission computed tomography (SPECT), positron (PET), cardiac magnetic resonance (CMR). Methods this PACIFIC-II substudy, 189 prior MI/PCI who were having symptoms related to ischemia underwent SPECT, PET, CMR before ICA evaluated inclusion. was obtained (109 patients) without (80 adherence QFR acquisition protocol. All major arteries interrogated FFR, except vessels subtotal/total occlusion. An FFR ≤0.80 used define significant epicardial CAD. analyses (v2.0) performed based on corelab in vascular territories (N=487) which obtained. modalities assessed presence corelabs, uninterpretable scans omitted from comparison analyses. Results analysis success rate higher (81%) among acquired using protocol (52%, p<0.001). Overall, result available 334 (69%) vessels. Among these vessels, had sensitivity (72%) accuracy (84%) SPECT (46%, p=0.001 66%, p<0.001), PET (58%, p=0.032 65%, (33%, p<0.001 72%, Whereas specificity (87%) similar (83%, p=0.123) but than that (71%, p<0.001) (67%, Lastly, exhibited area under receiver operating characteristic curve (0.89) (0.57, (0.66, (0.60, Conclusions Provided analyzable (69% vessels), correlated better (both as measures CAD) reflected detecting vessels-specific CAD defined FFR. Funding Acknowledgement Type funding sources: None.