title: CFR and FFR assessment with PET and CTA: strengths and limitations.
abstract: Positron emission tomography (PET) myocardial perfusion imaging (MPI) has high diagnostic accuracy and prognostic value. PET-MPI can also be used to quantitatively evaluate regional myocardial blood flow (MBF). This technique also allows the calculation of the coronary flow reserve (CFR)/myocardial flow reserve (MFR), which is the ratio of MBF at peak hyperemia to resting MBF. Coronary computed tomography angiography (CTA) is a non-invasive method for accurate detection and exclusion of high-grade coronary stenoses, when compared to an invasive coronary angiography reference standard. However, CTA assessment of coronary stenoses tends toward overestimation, and CTA cannot determine physiologic significance of lesions. Recent advances in computational fluid dynamics and image-based modeling permit calculation of non-invasive fractional flow reserve derived from CT (FFRCT), without the need for additional imaging, modification of acquisition protocols, or administration of medications. In this review, we cover the CFR/MFR assessment by PET and FFR assessment by CT.
authors.affiliation: St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Nakazato
authors.forename: Ran
authors.initials: R
authors.lastname: Heo
authors.forename: Jonathon
authors.initials: J
authors.lastname: Leipsic
authors.forename: James K
authors.initials: JK
authors.lastname: Min
mesh_terms: D003287:Contrast Media; D017023:Coronary Angiography; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D008297:Male; D008955:Models, Cardiovascular; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D049268:Positron-Emission Tomography / Q000379:methods; D011379:Prognosis; D011724:Pyridazines; D012015:Reference Standards; D012039:Regional Blood Flow; D015203:Reproducibility of Results
chemical_list: C525920:BMS 747158-02; D003287:Contrast Media; D011724:Pyridazines