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Coronary artery lumen volume index as a marker of flow-limiting atherosclerosis-validation against 13N-ammonia positron emission tomography.

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Title: Coronary artery lumen volume index as a marker of flow-limiting atherosclerosis-validation against 13N-ammonia positron emission tomography.
Authors: Benetos, Georgios1 (AUTHOR), Benz, Dominik C.1 (AUTHOR), Rampidis, Georgios P.1 (AUTHOR), Giannopoulos, Andreas A.1 (AUTHOR), von Felten, Elia1 (AUTHOR), Bakula, Adam1 (AUTHOR), Sustar, Aleksandra1 (AUTHOR), Fuchs, Tobias A.1 (AUTHOR), Pazhenkottil, Aju P.1 (AUTHOR), Gebhard, Catherine1 (AUTHOR), Kaufmann, Philipp A.1 (AUTHOR), Gräni, Christoph1,2 (AUTHOR), Buechel, Ronny R.1 (AUTHOR) Ronny.Buechel@usz.ch
Source: European Radiology. Jul2021, Vol. 31 Issue 7, p5116-5126. 11p. 1 Color Photograph, 2 Diagrams, 4 Charts, 3 Graphs.
Subjects: Positron emission tomography, Coronary arteries, Myocardial perfusion imaging, Computed tomography, Atherosclerosis
Abstract: Objectives: Coronary artery volume indexed to left myocardial mass (CAVi), derived from coronary computed tomography angiography (CCTA), has been proposed as an indicator of diffuse atherosclerosis. We investigated the association of CAVi with quantitative flow parameters and its ability to predict ischemia as derived from 13N-ammonia positron emission tomography myocardial perfusion imaging (PET-MPI).Methods: Sixty patients who underwent hybrid CCTA/PET-MPI due to suspected CAD were retrospectively included. CAVi was defined as total coronary artery lumen volume over myocardial mass, both derived from CCTA. From PET-MPI, quantitative stress and rest myocardial blood flow (MBF) and myocardial flow reserve (MFR) were obtained and correlated with CAVi, and semi-quantitative perfusion images were analyzed for the presence of ischemia. Harrell's c-statistic and net reclassification improvement (NRI) analysis were performed to evaluate the incremental value of CAVi over the CCTA model (i.e., stenosis > 50% and > 70%).Results: CAVi correlated moderately with stress MBF and MFR (R = 0.50, p < 0.001, and R = 0.39, p = 0.002). Mean stress MBF and MFR were lower in patients with low (i.e., ≤ 20.2 mm3/g, n = 24) versus high (i.e., > 20.2 mm3/g, n = 36) CAVi (p < 0.001 for both comparisons). CAVi was independently associated with abnormal stress MBF (OR 0.90, 95% CI 0.82-0.998, p = 0.045). CAVi increased the predictive ability of the CCTA model for abnormal stress MBF and ischemia (c-statistic 0.763 versus 0.596, pdiff < 0.05 and 0.770 versus 0.645, pdiff < 0.05, NRI 0.84, p = 0.001 and 0.96, p < 0.001, respectively).Conclusions: CAVi exhibits incremental value to predict both abnormal stress MBF and ischemia over CCTA alone.Key Points: • Coronary artery volume indexed to left myocardial mass (CAVi), derived from coronary computed tomography angiography (CCTA), is correlated with myocardial blood flow indices derived from 13N-ammonia positron emission tomography myocardial perfusion imaging. • CAVi is independently associated with abnormal stress myocardial blood flow. • CAVi provides incremental diagnostic value over CCTA for both abnormal stress MBF and ischemia. [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Coronary artery lumen volume index as a marker of flow-limiting atherosclerosis-validation against &lt;superscript&gt;13&lt;/superscript&gt;N-ammonia positron emission tomography.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Benetos%2C+Georgios%22&quot;&gt;Benetos, Georgios&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Benz%2C+Dominik+C%2E%22&quot;&gt;Benz, Dominik C.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Rampidis%2C+Georgios+P%2E%22&quot;&gt;Rampidis, Georgios P.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Giannopoulos%2C+Andreas+A%2E%22&quot;&gt;Giannopoulos, Andreas A.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22von+Felten%2C+Elia%22&quot;&gt;von Felten, Elia&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Bakula%2C+Adam%22&quot;&gt;Bakula, Adam&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Sustar%2C+Aleksandra%22&quot;&gt;Sustar, Aleksandra&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Fuchs%2C+Tobias+A%2E%22&quot;&gt;Fuchs, Tobias A.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Pazhenkottil%2C+Aju+P%2E%22&quot;&gt;Pazhenkottil, Aju P.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Gebhard%2C+Catherine%22&quot;&gt;Gebhard, Catherine&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Kaufmann%2C+Philipp+A%2E%22&quot;&gt;Kaufmann, Philipp A.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Gr&#228;ni%2C+Christoph%22&quot;&gt;Gr&#228;ni, Christoph&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Buechel%2C+Ronny+R%2E%22&quot;&gt;Buechel, Ronny R.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; Ronny.Buechel@usz.ch&lt;/i&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22European+Radiology%22&quot;&gt;European Radiology&lt;/searchLink&gt;. Jul2021, Vol. 31 Issue 7, p5116-5126. 11p. 1 Color Photograph, 2 Diagrams, 4 Charts, 3 Graphs.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Positron+emission+tomography%22&quot;&gt;Positron emission tomography&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Coronary+arteries%22&quot;&gt;Coronary arteries&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Myocardial+perfusion+imaging%22&quot;&gt;Myocardial perfusion imaging&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Computed+tomography%22&quot;&gt;Computed tomography&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Atherosclerosis%22&quot;&gt;Atherosclerosis&lt;/searchLink&gt;
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  Data: &lt;bold&gt;Objectives: &lt;/bold&gt;Coronary artery volume indexed to left myocardial mass (CAVi), derived from coronary computed tomography angiography (CCTA), has been proposed as an indicator of diffuse atherosclerosis. We investigated the association of CAVi with quantitative flow parameters and its ability to predict ischemia as derived from 13N-ammonia positron emission tomography myocardial perfusion imaging (PET-MPI).&lt;bold&gt;Methods: &lt;/bold&gt;Sixty patients who underwent hybrid CCTA/PET-MPI due to suspected CAD were retrospectively included. CAVi was defined as total coronary artery lumen volume over myocardial mass, both derived from CCTA. From PET-MPI, quantitative stress and rest myocardial blood flow (MBF) and myocardial flow reserve (MFR) were obtained and correlated with CAVi, and semi-quantitative perfusion images were analyzed for the presence of ischemia. Harrell&#39;s c-statistic and net reclassification improvement (NRI) analysis were performed to evaluate the incremental value of CAVi over the CCTA model (i.e., stenosis &gt; 50% and &gt; 70%).&lt;bold&gt;Results: &lt;/bold&gt;CAVi correlated moderately with stress MBF and MFR (R = 0.50, p &lt; 0.001, and R = 0.39, p = 0.002). Mean stress MBF and MFR were lower in patients with low (i.e., ≤ 20.2 mm3/g, n = 24) versus high (i.e., &gt; 20.2 mm3/g, n = 36) CAVi (p &lt; 0.001 for both comparisons). CAVi was independently associated with abnormal stress MBF (OR 0.90, 95% CI 0.82-0.998, p = 0.045). CAVi increased the predictive ability of the CCTA model for abnormal stress MBF and ischemia (c-statistic 0.763 versus 0.596, pdiff &lt; 0.05 and 0.770 versus 0.645, pdiff &lt; 0.05, NRI 0.84, p = 0.001 and 0.96, p &lt; 0.001, respectively).&lt;bold&gt;Conclusions: &lt;/bold&gt;CAVi exhibits incremental value to predict both abnormal stress MBF and ischemia over CCTA alone.&lt;bold&gt;Key Points: &lt;/bold&gt;• Coronary artery volume indexed to left myocardial mass (CAVi), derived from coronary computed tomography angiography (CCTA), is correlated with myocardial blood flow indices derived from 13N-ammonia positron emission tomography myocardial perfusion imaging. • CAVi is independently associated with abnormal stress myocardial blood flow. • CAVi provides incremental diagnostic value over CCTA for both abnormal stress MBF and ischemia. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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