Reliability and Reproducibility of Absolute Myocardial Blood Flow: Does It Depend on the PET/CT Technology, the Vasodilator, and/or the Software?

Autor: Monica B. Patel, Danai Kitkungvan, K. Lance Gould, Linh Bui
Rok vydání: 2021
Předmět:
medicine.medical_specialty
Technology
Coronary flow reserve
medicine.medical_treatment
Vasodilator Agents
Ischemia
Fractional flow reserve
Coronary Artery Disease
030204 cardiovascular system & hematology
Revascularization
Coronary Angiography
030218 nuclear medicine & medical imaging
Coronary artery disease
Cardiac positron emission tomography
03 medical and health sciences
Myocardial perfusion
0302 clinical medicine
Predictive Value of Tests
Internal medicine
Positron Emission Tomography Computed Tomography
medicine
Humans
Cardiac imaging
business.industry
Coronary Stenosis
Myocardial Perfusion Imaging
Coronary flow capacity
Reproducibility of Results
Blood flow
medicine.disease
Fractional Flow Reserve
Myocardial
Nuclear Cardiology (V Dilsizian
Section Editor)
Stenosis
Positron-Emission Tomography
Cardiology
Cardiology and Cardiovascular Medicine
business
Software
Zdroj: Current Cardiology Reports
ISSN: 1534-3170
Popis: Purpose of ReviewThe COURAGE and ISCHEMIA trials showed no reduced mortality after revascularization compared to medical treatment. Is this lack of benefit due to revascularization having no benefit regardless of CAD severity or to suboptimal patient selection due to non-quantitative cardiac imaging?Recent FindingsComprehensive, integrated, myocardial perfusion quantified by regional pixel distribution of coronary flow capacity (CFC) is the final common expression of objective CAD severity for which revascularization reduces mortality. Current lack of revascularization benefit derives from narrow thinking focused on measuring one isolated aspect of coronary characteristics, such as angiogram stenosis, its fractional flow reserve (FFR), anatomic FFR simulations, relative stress imaging, absolute stress ml/min/g or coronary flow reserve (CFR) alone, or even more narrowly on global CFR or fixed regions of interest in assumed coronary artery distributions, or in arbitrary 17 segments on bull’s-eye displays, rather than regional pixel distribution of perfusion metrics as they actually are in an individual.SummaryComprehensive integration of all quantitative perfusion metrics per regional pixel into coronary flow capacity guides artery-specific interventions for reduced mortality in non-acute CAD but requires addressing the methodologic questions in the title.
Databáze: OpenAIRE
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