PhD Scientific Days 2026

Poster Session 1.P - Cardiovascular Medicine and Research

Diagnostic and Prognostic Value of Myocardial Flow Reserve Quantification with Single Photon Emission Computed Tomography - a Systematic Review and Meta-Analysis

Name of the presenter

Baksa, Barnabas

Institute/workplace of the presenter

Medical Imaging Centre, Semmelweis University

Authors

Barnabas Baksa¹, Surendranath Sreeyapureddy Reddy¹, Sára Bundula², Samuel Beke¹, Réka Sebestyén-Dósa¹, István Csulak¹, Kristóf Nagy¹, Lili Száraz¹, Tamás Györke¹, Pál Maurovich-Horvat¹
1: Medical Imaging Centre, Semmelweis University
2: Medical Centre, Hungarian Defence Forces

Text of the abstract

Introduction: Myocardial flow reserve (MFR), assessed through dynamic single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI), provides a quantitative measure of coronary physiology, addressing some of the limitations of conventional semi-quantitative SPECT techniques.
Aims: This study aimed to systematically review and meta-analyze the diagnostic accuracy and prognostic value of SPECT-derived MFR compared to invasive coronary angiography (ICA), PET-MPI, and long-term clinical outcomes.
Methods: A comprehensive search of scientific databases identified studies comparing SPECT-derived MFR in patients with suspected or known coronary artery disease (CAD) to ICA, PET-MPI, or ≥12-month follow-up data for major adverse cardiac events (MACE). Meta-analysis was performed using random-effects models for studies comparing SPECT-MFR with PET-MPI, focusing on diagnostic metrics such as sensitivity and specificity.
Results: Thirty-two studies were included (19 comparing SPECT-MFR to ICA, 8 to PET-MPI, 1 to both, and 4 to long-term follow-up). Of these, thirty demonstrated a significant correlation between SPECT-derived MFR and reference standards, with excellent area under the curve (AUC) values (>0.7). In the meta-analysis of six PET-MPI comparator studies (n = 180 participants), the pooled sensitivity for SPECT-MFR was 78.5% (95% CI: 71.7-84.1%) and specificity was 89.3% (95% CI: 70.4-96.7%), yielding a diagnostic odds ratio of 15.7 (95% CI: 6.27-39.27). Prognostic studies confirmed that SPECT-MFR reliably predicted MACE, irrespective of the presence of obstructive coronary disease.
Conclusions: Quantitative MFR derived from dynamic SPECT-MPI correlates strongly with established diagnostic standards and independently predicts adverse cardiovascular events. While PET-MPI remains the reference standard, SPECT-MPI provides a viable, more accessible alternative. Further standardization of protocols and large-scale prospective studies are required to optimize the clinical application of SPECT-derived MFR.
Funding: SE 250+ Excellence PhD Scholarship.