Jamshid Maddahi
· ProfessorUniversity of California, Los Angeles · Nuclear Medicine & Theranostics
Active 1978–2026
About
Jamshid Maddahi is a professor in the Pharmacology Department at the University of California, Los Angeles. His research program focuses on evaluating the clinical impact of noninvasive assessment of tissue perfusion and metabolism on the management of patients with cardiac and oncologic diseases. Specifically, he studies the value of myocardial perfusion imaging at rest and during pharmacologic stress for detection of coronary artery disease and prediction of risk for myocardial infarction or mortality. Additionally, his work involves assessing PET metabolic indices of myocardial viability in patients with poor ventricular function to aid in cost-effective treatment planning aimed at improving patient outcomes such as mortality and heart failure symptoms. In the field of oncology, his research explores the use of PET metabolic imaging for determining metastatic spread and its overall impact on patient management at a lower cost.
Research topics
- Internal medicine
- Medicine
- Radiology
- Cardiology
- Nuclear medicine
Selected publications
Diagnostic performance of F-18 flurpiridaz in women: A sub-study of the Aurora Phase 3 trial
Journal of Nuclear Cardiology · 2026-01-21 · 1 citations
articleJournal of Nuclear Medicine · 2025-08-07
articleSenior author<sup>18</sup>F-flurpiridaz is a novel PET myocardial perfusion radiotracer with a high myocardial extraction fraction and low positron range, providing high-resolution images. Additionally, the linear relationship between <sup>18</sup>F-flurpiridaz myocardial extraction and myocardial blood flow (MBF) over a wide range of flow values permits accurate MBF measurement. Several groups have developed strategies to quantitate <sup>18</sup>F-flurpiridaz MBF with methodologic differences. These methods have not previously undergone head-to-head comparisons. <b>Methods:</b> Three methods of <sup>18</sup>F-flurpiridaz MBF quantitation were compared using Emory Cardiac Toolbox (ECTb; Syntermed), 4DM (INVIA), and Quantitative PET (QPET; Cedars-Sinai) software. All evaluable pharmacologic stress patients from the phase 3 <sup>18</sup>F-flurpiridaz PET trial (NCT03354273) of <sup>18</sup>F-flurpiridaz were included (<i>n</i> = 405). We adopted Bland–Altman plots to determine absolute differences between MBF quantitative methods, Fleiss κ for agreement across software packages, and Cohen κ for agreement of pairwise comparisons. Diagnostic performances of stress MBF and myocardial flow reserve (MFR) were determined by performing receiver-operating-characteristic analysis for areas under the curve (AUCs), using quantitative invasive coronary angiography as the reference standard. <b>Results:</b> Differences in mean stress MBF and MFR between methods across coronary territory distributions ranged from 0.23 to 0.29 mL/min/g and from 0.37 to 0.40 mL/min/g for ECTb and 4DM, respectively; from 0.09 to 0.11 mL/min/g and from 0.36 to 0.38 mL/min/g for ECTb and QPET, respectively; and from 0.25 to 0.26 mL/min/g and from 0.39 to 0.40 mL/min/g for QPET and 4DM, respectively. There was substantial agreement across software packages, with the Fleiss κ ranging from 0.77 to 0.79 and 0.72 to 0.75 for stress MBF and MFR, respectively. Similar results were found in pairwise comparisons. For coronary artery territories with at least 70% stenosis, median stress MBF and MFR AUCs were 0.73–0.74 and 0.71–0.73, respectively, when evaluated on a per-patient basis, and 0.75–0.77 and 0.74–0.75, respectively, in pooled coronary distributions on a per-vessel basis across all methods. <b>Conclusion:</b> All software packages demonstrated high agreement and similar <sup>18</sup>F-flurpiridaz MBF quantitation, paving the way for the interoperability of these platforms in clinical practice.
18F flurpiridaz PET MPI: Imaging characteristics and clinical trials
Journal of Nuclear Cardiology · 2025-03-01 · 7 citations
review1st authorCorrespondingJournal of Nuclear Medicine · 2025-09-18 · 1 citations
articleJournal of Nuclear Cardiology · 2025-09-23 · 3 citations
articleJournal of the American College of Cardiology · 2024-02-01 · 1 citations
letter1st authorCorrespondingEuropean Heart Journal · 2023-11-01
articleOpen access1st authorCorrespondingAbstract Background/Introduction Flurpiridaz F-18 (flurpiridaz) is a novel PET myocardial perfusion imaging tracer with outstanding imaging characteristics. Purpose To further assess the diagnostic efficacy and safety of flurpiridaz PET for the detection and evaluation of coronary artery disease (CAD) defined as &gt;50% stenosis by quantitative invasive coronary angiography (ICA) in a multi-center prospective international clinical trial. The primary end point was to assess the diagnostic efficacy (sensitivity and specificity) of flurpiridaz PET MPI for the detection of CAD. The secondary end points were to compare the diagnostic performance of flurpiridaz PET vs. Tc-99m SPECT in the detection of CAD in all patients and in the clinically important subgroups of women, obese [body mass index (BMI) ≥30 kg/m2], and diabetics. Also, PET and Tc-99m SPECT were compared for defect severity/extent, image quality, confidence of interpretation and radiation dose to patients. The safety of flurpiridaz PET was also evaluated. Methods 730 patients with suspected CAD from 48 clinical sites in US, Canada and Europe were enrolled. Patients underwent 1-day rest/stress (pharmacological or exercise) flurpiridaz PET and 1- or 2-day rest-stress Tc-99m labeled SPECT before ICA. PET and SPECT images were read by 3 experts blinded to clinical and ICA data. ICA was quantified by a core laboratory expert blinded to clinical and image data. Results 578 patients (age, 63.7±9.5 years) were evaluable. Flurpiridaz PET met the prespecified primary endpoint of the study; sensitivity and specificity were significantly higher than the prespecified threshold value by two of the three readers. The secondary endpoints were also met in the overall population, in women, in obese patients, and in diabetics. Flurpiridaz PET ROC area under the curves were significantly higher than SPECT in the overall population (0.80 vs 0.68, p&lt;0.0001), in women (0.84 vs 0.70, p&lt;0.01), and in obese patients (0.79 vs 0.67, p&lt;0.001), but not in diabetics (0.76 vs 0.69, p=0.088). Flurpiridaz PET was also superior to SPECT for assessment of defect extent/severity (p&lt;0.0001). Image quality (% excellent or good) of flurpiridaz PET was significantly better than SPECT for rest images (93% vs 72%, p&lt;0.0001), pharmacological stress images (96% vs 78%, p&lt;0.0001), and treadmill exercise images (97% vs 87%, p&lt;0.05). Radiation exposure, evaluated in 604 dosed patients, was less for PET than same-day rest/stress SPECT using either Tetrofosmin or Sestamibi with 6.25 mSv for flurpiridaz PET, 9.86 mSv for 99mTc-tetrofosmin SPECT and 12.41 mSv for 99mTc-sestamibi SPECT. Conclusion This second flurpiridaz PET myocardial perfusion imaging multicenter international trial demonstrates that flurpiridaz has promise as a new tracer for detection and evaluation of coronary artery disease. This is particularly so in women and patients with BMI≥30.
Flurpiridaz F-18 PET Myocardial Perfusion Imaging in Patients With Suspected Coronary Artery Disease
Journal of the American College of Cardiology · 2023 · 99 citations
1st authorCorresponding- Medicine
- Cardiology
- Internal medicine
European Journal of Nuclear Medicine and Molecular Imaging · 2021-12-30 · 38 citations
articleEuropean Heart Journal - Cardiovascular Imaging · 2021-11-29 · 32 citations
articleOpen accessSenior authorAIMS: We determined the feasibility and diagnostic performance of segmental 18F-flurpiridaz myocardial blood flow (MBF) measurement by positron emission tomography (PET) compared with the standard territory method, and assessed whether flow metrics provide incremental diagnostic value beyond relative perfusion quantitation (PQ). METHODS AND RESULTS: All evaluable pharmacological stress patients from the Phase III trial of 18F-flurpiridaz were included (n = 245) and blinded flow metrics obtained. For each coronary territory, the segmental flow metric was defined as the lowest 17-segment stress MBF (SMBF), myocardial flow reserve (MFR), or relative flow reserve (RFR) value. Diagnostic performances of segmental and territory MBF metrics were compared by receiver operating characteristic (ROC) areas under the curve (AUC). A multiple logistic model was used to evaluate whether flow metrics provided incremental diagnostic value beyond PQ alone. The diagnostic performances of segmental flow metrics were higher than their territory counterparts; SMBF AUC = 0.761 vs. 0.737; MFR AUC = 0.699 vs. 0.676; and RFR AUC = 0.716 vs. 0.635, respectively (P < 0.001 for all). Similar results were obtained for per-vessel coronary artery disease (CAD) ≥70% stenosis categorization and per-patient analyses. Combinatorial analyses revealed that only SMBF significantly improved the diagnostic performance of PQ in CAD ≥50% stenoses, with PQ AUC = 0.730, PQ + segmental SMBF AUC = 0.782 (P < 0.01), and PQ + territory SMBF AUC = 0.771 (P < 0.05). No flow metric improved diagnostic performance when combined with PQ in CAD ≥70% stenoses. CONCLUSION: Assessment of segmental MBF metrics with 18F-flurpiridaz is feasible and improves flow-based epicardial CAD detection. When combined with PQ, only SMBF provides additive diagnostic performance in moderate CAD.
Recent grants
NIH · $500k · 2019
NIH · $578k · 1992
NIH · $500k · 2018
NIH · $4.8M · 1990
NIH · $165k · 2015
Frequent coauthors
- 263 shared
Daniel S. Berman
Cedars-Sinai Medical Center
- 106 shared
Ernest Garcia
Emory University
- 65 shared
John D. Friedman
Cedars-Sinai Medical Center
- 64 shared
H.J.C. Swan
- 60 shared
Alan Rozanski
Mount Sinai Hospital
- 57 shared
Hosen Kiat
Australian National University
- 55 shared
Alan D. Waxman
University of New Mexico
- 48 shared
F Prigent
Centre Eugène Marquis
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