Stress Computed Tomography Myocardial Perfusion Imaging: A New Topic in Cardiology

Seitun, Sara; Morelli, Margherita Castiglione; Budaj, Irilda; Boccalini, Sara; Pregliasco, Athena Galletto; Valbusa, Alberto; Cademartiri, Filippo; Ferro, C.

doi:10.1016/j.rec.2015.10.018

Cited by 17 publications

(74 citation statements)

References 62 publications

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“…However, the advent of multidetector row (≥64 slices) CT systems, with improvement in temporal, spatial and contrast resolution as well as volume coverage due to increased detector rows, faster gantry rotation and smaller isotropic voxel size, allow CT to demonstrate myocardial perfusion at rest and during pharmacologic stress. Since 2005 with the first human report of CTP under adenosine stress condition by Kurata et al (13), several clinical studies, including recent multicenter trials, have established the value of myocardial CTP compared to reference standards as SPECT, ICA (with or without FFR) and stress perfusion MRI (14)(15)(16).…”

Section: Review Articlementioning

confidence: 99%

“…Therefore, CTP imaging has emerged from mere research application to its clinical use in the identification of myocardial ischemia during stress by using coronary vasodilator agents (adenosine, dipyridamole, or regadenoson), combining in the same examination both functional and anatomical information (16). Furthermore, a CT-derived FFR measurement computed from resting coronary CTA images (FFR-CT) that applies computational fluid dynamics and the transluminal attenuation gradient (TAG), an intracoronary attenuation-based analysis of coronary CTA, have been recently introduced (17,18).…”

Section: Review Articlementioning

confidence: 99%

“…A combined coronary CTA/CTP imaging protocol could be performed according to the rest/stress or stress/rest sequences, separated by 10-15 minutes to allow for contrast wash-out ( Figure 1) (12,16).…”

Section: Ctp Imaging Protocolsmentioning

confidence: 99%

“…Indeed, stress CTP imaging could only be selectively performed in patients with intermediate or obstructive coronary stenosis to assess the physiological significance of CAD (16). This approach will obviate need for further testing with reductions in the radiation and contrast medium doses.…”

Section: Ctp Imaging Protocolsmentioning

confidence: 99%

“…This approach will obviate need for further testing with reductions in the radiation and contrast medium doses. This protocol is highly sensitive for the detection of necrosis, however, the risk of crosscontamination of contrast in the stress phase and the use of beta-blockers, may confound perfusion defects and decrease the sensitivity for myocardial ischemia (16).…”

Section: Ctp Imaging Protocolsmentioning

confidence: 99%

See 4 more Smart Citations

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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Section: Review Articlementioning

confidence: 99%

Section: Review Articlementioning

confidence: 99%

Section: Ctp Imaging Protocolsmentioning

confidence: 99%

Section: Ctp Imaging Protocolsmentioning

confidence: 99%

Section: Ctp Imaging Protocolsmentioning

confidence: 99%

See 3 more Smart Citations

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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Basis and current state of computed tomography perfusion imaging: a review

Zeng¹,

Zeng²,

Sui³

et al. 2022

Phys. Med. Biol.

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Computed tomography perfusion (CTP) is a functional imaging that allows for providing capillary-level hemodynamics information of the desired tissue in clinics. In this paper, we aim to offer insight into CTP imaging which covers the basics and current state of CTP imaging, then summarize the technical applications in the CTP imaging as well as the future technological potential. At first, we focus on the fundamentals of CTP imaging including systematically summarized CTP image acquisition and hemodynamic parameter map estimation techniques. A short assessment is presented to outline the clinical applications with CTP imaging, and then a review of radiation dose effect of the CTP imaging on the different applications is presented. We present a categorized methodology review on known and potential solvable challenges of radiation dose reduction in CTP imaging. To evaluate the quality of CTP images, we list various standardized performance metrics. Moreover, we present a review on the determination of infarct and penumbra. Finally, we reveal the popularity and future trend of CTP imaging.

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First Experience With a Whole-Body Spectral Photon-Counting CT Clinical Prototype

et al. 2023

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Spectral photon-counting computed tomography (SPCCT) technology holds great promise for becoming the next generation of computed tomography (CT) systems. Its technical characteristics have many advantages over conventional CT imaging. For example, SPCCT provides better spatial resolution, greater dose efficiency for ultra-low-dose and low-dose protocols, and tissue contrast superior to that of conventional CT. In addition, SPCCT takes advantage of several known approaches in the field of spectral CT imaging, such as virtual monochromatic imaging and material decomposition imaging. In addition, SPCCT takes advantage of a new approach in this field, known as K-edge imaging, which allows specific and quantitative imaging of a heavy atom-based contrast agent. Hence, the high potential of SPCCT systems supports their ongoing investigation in clinical research settings. In this review, we propose an overview of our clinical research experience of a whole-body SPCCT clinical prototype, to give an insight into the potential benefits for clinical human imaging on image quality, diagnostic confidence, and new approaches in spectral CT imaging.

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Stress Computed Tomography Myocardial Perfusion Imaging: A New Topic in Cardiology

Cited by 17 publications

References 62 publications

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

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

Basis and current state of computed tomography perfusion imaging: a review

First Experience With a Whole-Body Spectral Photon-Counting CT Clinical Prototype

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