Diagnostic value of transmural perfusion ratio derived from dynamic CT-based myocardial perfusion imaging for the detection of haemodynamically relevant coronary artery stenosis

Coenen, Adriaan; Lubbers, Marisa; Kurata, Akira; Kono, Atsushi K.; Dedic, Admir; Chelu, Raluca G.; Dijkshoorn, Marcel L.; Rossi, Alexia; Geuns, Robert Jan van; Nieman, Koen

doi:10.1007/s00330-016-4567-0

Cited by 36 publications

(14 citation statements)

References 31 publications

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“…The ECG-triggered axial shuttle mode available on dual-source CT allows acquisition of a dynamic CTP dataset for the whole heart en bloc using rapid movement between two table positions. Although the dynamic acquisitions are performed every third or more heartbeat, dynamic CTP with dual-source CT has been reported to have good diagnostic performance for detecting a myocardial perfusion abnormality [34]. Wide-detector CT (e.g., 256 or 320 slice detectors, with 8 cm/16 cm z-coverage) enables acquisition of data in consecutive heartbeats, providing whole-heart perfusion without temporal gaps [30,35].…”

Section: Dynamic Ctp Imagingmentioning

confidence: 99%

Computed tomographic evaluation of myocardial ischemia

et al. 2020

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Myocardial ischemia is caused by a mismatch between myocardial oxygen consumption and oxygen delivery in coronary artery disease (CAD). Stratification and decision-making based on ischemia improves the prognosis in patients with CAD. Non-invasive tests used to evaluate myocardial ischemia include stress electrocardiography, echocardiography, single-photon emission computed tomography, and magnetic resonance imaging. Invasive fractional flow reserve is considered the reference standard for assessment of the hemodynamic significance of CAD. Computed tomography (CT) angiography has emerged as a first-line imaging modality for evaluation of CAD, particularly in the population at low to intermediate risk, because of its high negative predictive value; however, CT angiography does not provide information on the hemodynamic significance of stenosis, which lowers its specificity. Emerging techniques, e.g., CT perfusion and CT-fractional flow reserve, help to address this limitation of CT, by determining the hemodynamic significance of coronary artery stenosis. CT perfusion involves acquisition during the first pass of contrast medium through the myocardium following pharmacological stress. CTfractional flow reserve uses computational fluid dynamics to model coronary flow, pressure, and resistance. In this article, we review these two functional CT techniques in the evaluation of myocardial ischemia, including their principles, technology, advantages, limitations, pitfalls, and the current evidence.

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Section: Dynamic Ctp Imagingmentioning

confidence: 99%

Computed tomographic evaluation of myocardial ischemia

et al. 2020

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“…Diagnostic performance of dynamic CTP has been validated against different reference standards including MRI [42][43][44][45], SPECT [43,46,47], and coronary angiography with FFR measurement [21,27,[48][49][50][51][52][53]. Available data are scarce on the diagnostic performance of dynamic CTP for detecting perfusion defects determined by MRI or SPECT.…”

Section: Diagnostic Performance Of Dynamic Ctpmentioning

confidence: 99%

Dynamic CT Perfusion Imaging: State of the Art

Kitagawa

Goto

Nakamura

et al. 2018

Cardiovasc Imaging Asia

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Recent advances in computed tomography (CT) technology have enabled stress dynamic CT perfusion (CTP) imaging of the entire myocardium to be performed with high temporal resolution and reasonable radiation dose. The most important advantage of dynamic CTP is the feasibility of complete quantification of myocardial perfusion in mL/min/g. Although high diagnostic values have been reported for the detection of myocardial ischemia, standardization of acquisition method, mathematical modeling and interpretation, as well as further evaluation of its accuracy, clinical role, and cost effectiveness are required before its routine clinical implementation. The current review focuses on the state-of-the-art of dynamic CTP and outlines its current status and future directions as a new technology for the physiologic assessment of coronary artery disease.

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“…Similarly, a recent study by dynamic CTP showed that the TPR was inferior to quantified MBF with limited incremental value (77). Finally, it is clearly important to establish the prognostic utility of CTP imaging beyond its diagnostic capabilities since myocardial perfusion imaging is widely used for risk stratification in clinical practice.…”

Section: Ctp Imagingmentioning

confidence: 99%

Myocardial blood flow quantification for evaluation of coronary artery disease by computed tomography

Cademartiri

Seitun

Clemente

et al. 2017

Cardiovasc. Diagn. Ther.

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During the last decade coronary computed tomography angiography (CTA) has become the preeminent noninvasive imaging modality to detect coronary artery disease (CAD) with high accuracy.However, CTA has a limited value in assessing the hemodynamic significance of a given stenosis due to a modest specificity and positive predictive value. In recent years, different CT techniques for detecting myocardial ischemia have emerged, such as CT-derived fractional flow reserve (FFR-CT), transluminal attenuation gradient (TAG), and myocardial CT perfusion (CTP) imaging. Myocardial CTP imaging can be performed with a single static scan during first pass of the contrast agent, with monoenergetic or dualenergy acquisition, or as a dynamic, time-resolved scan during stress by using coronary vasodilator agents (adenosine, dipyridamole, or regadenoson). A number of CTP techniques are available, which can assess myocardial perfusion in both a qualitative, semi-quantitative or quantitative manner. Once used primarily as research tools, these modalities are increasingly being used in routine clinical practice. All these techniques offer the substantial advantage of combining anatomical and functional evaluation of flow-limiting coronary stenosis in the same examination that would be beneficial for clinical decision-making. This review focuses on the state-of the-art and future trends of these evolving imaging modalities in the field of cardiology for the physiologic assessments of CAD.

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Diagnostic value of transmural perfusion ratio derived from dynamic CT-based myocardial perfusion imaging for the detection of haemodynamically relevant coronary artery stenosis

Cited by 36 publications

References 31 publications

Computed tomographic evaluation of myocardial ischemia

Computed tomographic evaluation of myocardial ischemia

Dynamic CT Perfusion Imaging: State of the Art

Myocardial blood flow quantification for evaluation of coronary artery disease by computed tomography

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