Quantification of myocardial blood flow using dynamic 320-row multi-detector CT as compared with 15O-H2O PET

Kikuchi, Yasumoto; Oyama‐Manabe, Noriko; Naya, Masanao; Manabe, Osamu; Tomiyama, Yoshiaki; Sasaki, Tsukasa; Katoh, Chietsugu; Kudo, Kohsuke; Tamaki, Nagara; Shirato, Hiroki

doi:10.1007/s00330-014-3164-3

Cited by 90 publications

(72 citation statements)

References 37 publications

(12 reference statements)

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“…Most of these were performed in a limited number of patients and using different scanner generations, showing high sensitivity and negative predictive value, and moderate specificity and positive predictive value. Newer single center studies have shown improved positive predictive value as well as specificity, being validated by two large multicenter trials (43)(44)(45)(46).…”

Section: Introductionmentioning

confidence: 99%

Myocardial CT perfusion imaging for ischemia detection

Carrascosa

Capuñay

2017

Cardiovasc. Diagn. Ther.

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Section: Introductionmentioning

confidence: 99%

Myocardial CT perfusion imaging for ischemia detection

Carrascosa

Capuñay

2017

Cardiovasc. Diagn. Ther.

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“…Part of the study population (22 out of 51) was compared to 15 O-H 2 O positron emission tomography (PET). 15 O-H 2 O allows for free diffusion (100 % extraction fraction) and is linearly correlated with myocardial uptake [27,28].…”

Section: Ct-mpi In Non-obstructive Cad and Microvascular Diseasementioning

confidence: 99%

CT myocardial perfusion imaging: ready for prime time?

2017

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The detection of functional coronary artery stenosis with coronary CT angiography (CCTA) is suboptimal. Additional CT myocardial perfusion imaging (CT-MPI) may be helpful to identify patients with myocardial ischaemia in whom coronary revascularization therapy would be beneficial. CT-MPI adds incremental diagnostic and prognostic value over obstructive disease on CCTA. It allows for the quantitation of myocardial blood flow and calculation of coronary flow reserve and shows good correlation with 15 O-H 2 O positron emission tomography and invasive fractional flow reserve. In addition, patients prefer CCTA/CT-MPI over SPECT, MRI and invasive coronary angiography. CT-MPI is ready for clinical use for detecting myocardial ischaemia caused by obstructive disease. Nevertheless, the clinical utility of CT-MPI to identify ischaemia in patients with non-obstructive/microvascular disease still has to be established. Key Points• CT-MPI can improve the positive predictive value of CCTA for lesion-specific ischaemia.• CT-MPI adds incremental prognostic value over CCTA for major adverse cardiac events.• CT-MPI correlates with 15O-H 2 O PET.• CT-MPI/CCTA shows high overall patient satisfaction.

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“…CFR is now available noninvasively on multimodalities such as dynamic CT or MRI perfusion scan (15,16), SPECT (17), and flow velocity on MRI (18). The cold pressor test (CPT) is another method for stress testing in addition to adenosine stress.…”

Section: Future Directions and Alternativesmentioning

confidence: 99%

Clinical Applications of Coronary Flow Reserve in Patients with Coronary Artery Disease

Naya

Manabe

2017

Annals of Nuclear Cardiology

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Coronary artery disease (CAD) is one of the major causes of death in Japan. Fractional flow reserve with angiography is a well validated method for identifying significant focal stenosis, but is not applied for the estimation of hyperemic vasodilatory capacity in the myocardium. Coronary flow reserve (CFR) estimated from sequential myocardial perfusion images obtained by blood flow tracers and positron emission tomography (PET) is a quantitative value. CFR is regulated not only by focal stenoses but also by diffuse atherosclerosis and coronary microvascular dysfunction (CMD) in patients with CAD. Accordingly, low CFR is shown to be a strong predictor of cardiac death in combination with anatomical disease burden. Optimal medical therapies such as beta-blockers, angiotensin converting enzyme (ACE) inhibitors, statins, and medications for diabetes could increase CFR by improving CMD at the early stage of CAD. It is also important to clarify the effects of coronary revascularization for focal stenoses on CFR. This paper focuses on the application of CFR estimated by cardiac PET to the evaluation of per-patient atherosclerotic burden and microvascular dysfunction.

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Quantification of myocardial blood flow using dynamic 320-row multi-detector CT as compared with 15O-H2O PET

Cited by 90 publications

References 37 publications

Myocardial CT perfusion imaging for ischemia detection

Myocardial CT perfusion imaging for ischemia detection

CT myocardial perfusion imaging: ready for prime time?

Clinical Applications of Coronary Flow Reserve in Patients with Coronary Artery Disease

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