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02.11.2018 | Original Article

Comparison of diagnostic accuracy of PET-derived myocardial blood flow parameters: A meta-analysis

Journal of Nuclear Cardiology
MD, PhD Sang-Geon Cho, MD, PhD Soo Jin Lee, PhD Myung Hwan Na, MD, PhD Yun Young Choi, MD, PhD Henry Hee-Seung Bom
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Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s12350-018-01476-z) contains supplementary material, which is available to authorized users.
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This study was supported by a Grant (NRF-2016R1D1A3B01006631) of the Basic Science Research Program through the National Research Foundation (NRF) funded by the Ministry of Education, Republic of Korea.
Sang-Geon Cho and Soo Jin Lee have equally contributed to this work.
All editorial decisions for this article, including selection of reviewers and the final decision, were made by guest editor Henry Gewirtz, MD.



Although absolute quantification of myocardial blood flow (MBF) by positron emission tomography provides additive diagnostic value to visual analysis of perfusion defect, diagnostic accuracy of different MBF parameters remain unclear.


Clinical studies regarding the diagnostic accuracy of hyperemic MBF (hMBF), myocardial flow reserve (MFR) and/or relative flow reserve (RFR) were searched and systematically reviewed. On a per-vessel basis, pooled measures of the parameters’ diagnostic performances were analyzed, regarding significant coronary stenosis defined by fractional flow reserve or diameter stenosis.


Ten studies (2,522 arteries from 1,099 patients) were finally included. Pooled sensitivity [95% confidence interval (CI)] was 0.853 (0.821-0.881) for hMBF, 0.755 (0.713-0.794) for MFR, and 0.636 (0.539-0.726) for RFR. Pooled specificity (95% CI) was 0.844 (0.827-0.860) for hMBF, 0.804 (0.784-0.824) for MFR, and 0.897 (0.860-0.926) for RFR. Pooled area under the curve ± standard error was 0.900 ± 0.020 for hMBF, 0.830 ± 0.026 for MFR, and 0.873 ± 0.048 for RFR.


hMBF showed the best sensitivity while RFR showed the best specificity in the diagnosis of significant coronary stenosis. MFR was less sensitive than hMBF and less specific than hMBF and RFR.

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Supplementary material 1 (DOCX 2452 kb)
Supplementary material 2 (PPTX 193 kb)
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