PET Versus Invasive Provocation Testing Accuracy for Coronary Microvascular Disease: A Single-Center Review.

BACKGROUND: Despite substantial evidence supporting the accuracy of positron emission tomography (PET) for detecting epicardial disease, there are limited data regarding the accuracy of PET for cardiac microvascular disease (CMD). PROJECT RATIONALE: Defining the accuracy of PET for CMD detection could establish PET as a single noninvasive modality for evaluating both epicardial and microvascular coronary function, with less risk and cost when compared with invasive assessment. PROJECT SUMMARY: This is a single-center, retrospective, diagnostic accuracy study to assess the accuracy of PET for diagnosing microvascular disease using invasive coronary angiography, with comprehensive coronary function testing as the gold standard. TAKE-HOME MESSAGES: In this small cohort (N = 15), PET demonstrated poor diagnostic accuracy for CMD detection compared to invasive coronary angiography with invasive provocation testing. The high prevalence of epicardial vasospasm (47%) suggests this entity may be underdiagnosed in patients with recurrent angina and nonobstructive coronary disease.