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Current Cardiology Reports

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Open Access 01-04-2020 | Positron Emission Tomography | Nuclear Cardiology (V Dilsizian, Section Editor)

How Do PET Myocardial Blood Flow Reserve and FFR Differ?

Authors: Nils P. Johnson, K. Lance Gould

Published in: Current Cardiology Reports | Issue 4/2020

Abstract

Purpose of Review

This review discusses similarities and differences between cardiac positron emission tomography (PET), absolute myocardial blood flow, and flow reserve with invasive fractional flow reserve (FFR).

Recent Findings

Fundamentally, cardiac PET measures absolute myocardial blood flow whereas FFR provides a relative flow reserve. Cardiac PET offers a non-invasive and therefore lower risk alternative, able to image the entire left ventricle regardless of coronary anatomy. While cardiac PET can provide unique information about the subendocardium, FFR pullbacks offer unparalleled spatial resolution. Both diagnostic tests provide a highly repeatable and technically successful index of coronary hemodynamics that accounts for the amount of distal myocardial mass, albeit only indirectly with FFR. The randomized evidence base for FFR and its associated cost effectiveness remains unsurpassed.

Summary

Cardiac PET and FFR have been intertwined since the very development of FFR over 25 years ago. Recent work has emphasized the ability of both techniques to guide revascularization decisions by high-quality physiology. In the past few years, cardiac PET has expanded its evidence base regarding clinical outcomes, whereas FFR has solidified its position in randomized studies as the invasive reference standard.

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Title: How Do PET Myocardial Blood Flow Reserve and FFR Differ?
Authors: Nils P. Johnson
K. Lance Gould
Publication date: 01-04-2020
Publisher: Springer US
Keyword: Positron Emission Tomography
Published in: Current Cardiology Reports / Issue 4/2020
Print ISSN: 1523-3782
Electronic ISSN: 1534-3170
DOI: https://doi.org/10.1007/s11886-020-1274-x

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