Update of ¹⁸F-flurpiridaz

Area of Science:

• Cardiovascular Imaging
• Nuclear Cardiology
• Radiopharmaceutical Development

Background:

• Coronary artery disease (CAD) diagnosis relies on accurate myocardial perfusion imaging.
• Traditional SPECT imaging has limitations in sensitivity and specificity for detecting significant coronary artery stenosis.
• ¹⁸F-flurpiridaz is a novel PET tracer developed for myocardial perfusion imaging.

Purpose of the Study:

• To evaluate the diagnostic performance of ¹⁸F-flurpiridaz PET compared to SPECT in detecting coronary artery stenosis.
• To assess the accuracy of ¹⁸F-flurpiridaz in a broader patient population, including women and obese individuals.
• To explore the potential of ¹⁸F-flurpiridaz for functional ischemia assessment and cardiac event prediction.

Main Methods:

• Phase III clinical trials comparing ¹⁸F-flurpiridaz PET with ^99mTc-SPECT.
• Assessment of sensitivity and specificity for detecting ≥50% coronary artery stenosis.
• Analysis of diagnostic accuracy in subgroups, including women and obese patients.

Main Results:

• ¹⁸F-flurpiridaz PET demonstrated higher sensitivity (80.3%) than SPECT (53.7%) in the AURORA trial.
• ¹⁸F-flurpiridaz PET met the non-inferiority criterion for specificity (63.8%) compared to SPECT.
• Superior diagnostic accuracy was observed with ¹⁸F-flurpiridaz PET, particularly in women and obese patients.

Conclusions:

• ¹⁸F-flurpiridaz PET represents a significant advancement in the diagnosis of coronary artery disease.
• The tracer offers improved sensitivity and specificity over SPECT for detecting significant coronary artery stenosis.
• Its ability to measure coronary blood flow reserve suggests potential for enhanced functional ischemia assessment and cardiac event prediction.