Myocardium: Dynamic versus Single-Shot CT Perfusion Imaging

Abstract

http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.13121441/-/DC1.

Optimal Scan Time for Single-Phase Myocardial Computed Tomography Perfusion to Detect Myocardial Ischemia – Derivation Cohort From Dynamic Myocardial Computed Tomography Perfusion –

“…18 Our study also showed that the time point of maximal enhancement was later and the peak CT attenuation was lower in ischemic myocardium, compared with normal myocardium. Among the 11 series of single-phase CTP images, the singlephase CTP image acquired at 2-6 s from Tmax in the ascending aorta had high accuracy for detecting myocardial ischemia and was comparable to dynamic CTP.…”

“…Huber et al also indicated that single-phase CTP had a similar performance to the dynamic CTP in the detection of myocardial ischemia if the single-phase CTP was acquired at the optimal scan time. 18 This optimal time period is also beneficial when using 64-slice CT to obtain single-phase CTP images at suboptimal scan timing. However, the optimal scan time may vary substantially according to each case, because the Tmax in the ascending aorta is not necessarily always the same, and it is difficult to determine the optimal scan timing using a conventional bolus tracking technique.…”

Evaluation of static and dynamic perfusion cardiac computed tomography for quantitation and classification tasks

“…A majority of prior work evaluates the ability of CT myocardial perfusion assessment to identify physiologically significant epicardial disease. 5,10,11,[21][22][23] Several studies have shown that CT perfusion can improve the specificity and positive predictive value of CT angiography (for static, 23 and for dynamic 10,11 ). However, not all perfusion defects are linked to a focal stenosis.…”

“…In one notable exception, Huber et al 5 directly compared dynamic and static performance for the detection of hemodynamically relevant coronary stenoses. Consistent with our findings, these authors concluded that static and dynamic methods have similar detection performance.…”

“…There is an open debate regarding the preferred mode, and the only direct comparison to date has a very small sample size and limited patient population. 5 Considered on its own, static CT myocardial perfusion assessment has been shown to have incremental value in improving the specificity and positive predictive value when combined with anatomical stenosis information from cardiac CT angiography (CCTA) and correlates with rest and stress single photon emission computed tomography myocardial perfusion imaging (SPECT MPI) 6 and with cardiac magnetic resonance imaging perfusion assessment. 7 Previous animal studies have demonstrated that dynamic CT myocardial perfusion assessment is strongly correlated with gold standard microsphere perfusion measurements 8 and coronary flow probe measurements.…”