Both Percent Diameter Stenosis (%DS) and Coronary Flow Reserve (CFR) can be Derived Directly from Myocardial Perfusion Imaging (MPI) using FMTVDM © ℗ and Measurement of Isotope Redistribution

Abstract

Background: Scientifically published studies have demonstrated that all isotopes, including Sestamibi redistribute. Measurement of this redistribution using FMTVDM©℗ provides an accurate method for determining wash-in and washout. Methods: Using FMTVDM©℗ 1040 human coronary arteries were studied to determine their wash-in and washout redistribution measured on a pixel-by-pixel basis. From FMTVDM©℗ the percent diameter stenosis (%DS) for each artery was determined. This %DS was then used to calculate coronary flow reserve (Calculated SFR) using a proprietary quadratic equation (QCFR©, FCFR©) previously derived from quantitative coronary arteriography (QCA) measurements. These calculated CFR values were then compared with the actual measured CFR obtained directly from QCA. Results: The results of the calculated CFR from FMTVDM©℗ with that obtained by direct QCA measurement showed a regression analysis of y= (0.8758•x)+0.4291, where y=the QCFR© and x=the QCA measured CFR. The R2 value (coefficient of determination) for this demonstrated a strong relationship at 0.87582. Conclusions: The use of the FMTVDM©℗ for measurement of isotope redistribution, including Sestamibi, provides an accurate quantitative method for determining both redistribution wash-in and redistribution washout, from which %DS can be calculated on a pixel-by-pixel basis. This %DS can then be used with the proprietary equation (QCFR©, FCFR©) to calculate the CFR directly from the MPI result using FMTVDM©℗. The implementation of this power tool, will provide for additional determination of the physiological effect of CAD without requiring additional QCA equipment and expertise costs, making QCFR© possible in most if not all hospitals with nuclear medicine departments.