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01-10-2021 | Arterial Diseases | ORIGINAL ARTICLE

Added value of myocardial blood flow using ¹⁸F-flurpiridaz PET to diagnose coronary artery disease: The flurpiridaz 301 trial

Authors: Jonathan B. Moody, PhD, Alexis Poitrasson-Rivière, PhD, Tomoe Hagio, PhD, Christopher Buckley, PhD, Richard L. Weinberg, MD, PhD, James R. Corbett, MD, Venkatesh L. Murthy, MD, PhD, Edward P. Ficaro, PhD

Published in: Journal of Nuclear Cardiology | Issue 5/2021

Abstract

Background

¹⁸F-Flurpiridaz is a promising investigational radiotracer for PET myocardial perfusion imaging with favorable properties for quantification of myocardial blood flow (MBF). We sought to validate the incremental diagnostic value of absolute MBF quantification in a large multicenter trial against quantitative coronary angiography.

Methods

We retrospectively analyzed a subset of patients (N = 231) from the first phase 3 flurpiridaz trial (NCT01347710). Dynamic PET data at rest and pharmacologic stress were fit to a previously validated 2-tissue-compartment model. Absolute MBF and myocardial flow reserve (MFR) were compared with coronary artery disease severity quantified by invasive coronary angiography on a per-patient and per-vessel basis.

Results

Stress MBF per-vessel accurately identified obstructive disease (c-index 0.79) and progressively declined with increasing stenosis severity (2.35 ± 0.71 in patients without CAD; 1.92 ± 0.49 in non-obstructed territories of CAD patients; and 1.54 ± 0.50 in diseased territories, P < 0.05). MFR similarly declined with increasing stenosis severity (3.03 ± 0.94; 2.69 ± 0.95; and 2.33 ± 0.86, respectively, P < 0.05). In multivariable logistic regression modeling, stress MBF and MFR provided incremental diagnostic value beyond patient characteristics and relative perfusion analysis.

Conclusions

Clinical myocardial blood flow measurement with ¹⁸F-flurpiridaz cardiac PET shows promise for routine application.

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Title: Added value of myocardial blood flow using 18F-flurpiridaz PET to diagnose coronary artery disease: The flurpiridaz 301 trial
Authors: Jonathan B. Moody, PhD
Alexis Poitrasson-Rivière, PhD
Tomoe Hagio, PhD
Christopher Buckley, PhD
Richard L. Weinberg, MD, PhD
James R. Corbett, MD
Venkatesh L. Murthy, MD, PhD
Edward P. Ficaro, PhD
Publication date: 01-10-2021
Publisher: Springer International Publishing
Keywords: Arterial Diseases
Positron Emission Tomography
Published in: Journal of Nuclear Cardiology / Issue 5/2021
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI: https://doi.org/10.1007/s12350-020-02034-2

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