Transient Ischemic Dilation with 18F-flurpiridaz PET: Establishing Thresholds for a Novel Radiotracer

作者：Sevan Letourneau-Shesaf, Yi-Min Chen, M. Lemley, G. Ramirez, P. Kavanagh, A. Shanbhag, Joanna X. Liang, C. Buckley, Robert J. H. Miller, Daniel S. Berman, P. Slomka · 发表于：Journal of Nuclear Cardiology · 年份：2026 · DOI：10.1016/j.nuclcard.2026.102806 · 被引用次数：2 · 研究领域：Medicine

Background Transient ischemic dilation (TID) of the LV is a specific marker of extensive coronary artery disease (CAD). Normal limits for TID using 18F-flurpiridaz have not been established. Methods We performed a secondary analysis of the multicenter phase III Flurpiridaz-301 trial, which included patients with suspected CAD who underwent rest–stress 18F-flurpiridaz positron emission tomography (PET), Tc-99m single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI), and invasive coronary angiography (ICA). TID was calculated using ungated left ventricular volumes. Stress-specific reference thresholds were derived in patients without angiographic CAD. The effects of stress modality, CAD severity, and post-reconstruction Gaussian filtering on TID measurements were evaluated. Results Among 746 patients with evaluable PET, SPECT, and angiographic data, stress-specific TID reference thresholds (97.5th percentile) for 18F-flurpiridaz PET using a 5-mm Gaussian filter were 1.18 for exercise stress and 1.25 for pharmacologic stress. Corresponding Tc-99m SPECT thresholds were lower. PET-derived TID values increased progressively with angiographically defined CAD severity, demonstrating a graded association across disease categories. Application of post-reconstruction Gaussian filtering resulted in lower PET-derived TID values compared with unfiltered images, with modest differences between 5-mm and 8-mm filters. Conclusion This study suggests stress-specifi...