Stress Computed Tomography Perfusion Versus Fractional Flow Reserve CT Derived in Suspected Coronary Artery Disease

Pontone, Gianluca; Baggiano, Andrea; Andreini, Daniele; Guaricci, Andrea Igoren; Guglielmo, Marco; Muscogiuri, Giuseppe; Fusini, Laura; Fazzari, Fabio; Mushtaq, Saima; Conte, Edoardo; Calligaris, Giuseppe; Martini, Stefano De; Ferrari, Cristina; Galli, Stefano; Grancini, Luca; Ravagnani, Paolo; Teruzzi, Giovanni; Trabattoni, Daniela; Fabbiocchi, Franco; Lualdi, Alessandro; Montorsi, Piero; Rabbat, Mark; Bartorelli, Antonio L.; Pepi, Mauro

doi:10.1016/j.jcmg.2018.08.023

Cited by 90 publications

(72 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Moreover, the CORE320 study (n = 381) demonstrated that static CTP has incremental diagnostic value over CTA for detection of hemodynamically significant coronary lesions, with a specificity of 74% vs 51% for CTA, a PPV of 65% vs 53%, and an area under the receiver-operating characteristic curve (AUC) of 0.87 vs 0.84 [91]. Pontone et al (n = 147) reported similar results in static CTP (a specificity of 95% vs 76% for CTA and a PPV of 87% vs 61%) [92]. The CRESCENT-II trial indicated that incorporation of dynamic CTP imaging as part of a tiered diagnostic approach could improve the clinical value and efficiency of cardiac CT in the diagnostic work-up of patients with stable CAD and was an effective alternative to standard guideline-directed functional testing [93].…”

Section: Current Evidence Of Ctpmentioning

confidence: 89%

See 1 more Smart Citation

Computed tomographic evaluation of myocardial ischemia

et al. 2020

View full text Add to dashboard Cite

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.

show abstract

Section: Current Evidence Of Ctpmentioning

confidence: 89%

“…Quantification (CT-MBF using dynamic CTP) Incremental value to coronary CTA better diagnostic performance than CTA alone [92]. Integrated CTP and CT-FFR has better performance than either of these techniques used alone [81].…”

Section: Which Ct Imaging Technique Is Best For Ischemia?mentioning

confidence: 99%

Computed tomographic evaluation of myocardial ischemia

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In the Diagnostic Accuracy of Fractional Flow Reserve from Anatomic CT Angiography, or DEFACTO, trial, misalignment artifacts resulted in impaired sensitivity and single-source scanners. Previous studies with dual-source technology show that image quality is less dependent on HR as compared to 64-section single-source coronary CT (17,18) and that wide-coverage scanner technology allows for single-beat whole-heart acquisition, reducing the occurrence of motion or step artifacts (19,20). Despite these advances in CT hardware over the past 2 decades, HR continues to be closely associated with image quality at coronary CT angiography (21).…”

Section: Clinical Cohortmentioning

confidence: 99%

Determinants of Rejection Rate for Coronary CT Angiography Fractional Flow Reserve Analysis

Weir‐McCall¹,

Baggiano²,

Torto³

et al. 2019

Radiology

Self Cite

View full text Add to dashboard Cite

oronary artery disease is a major cause of mortality and morbidity, and its management consumes a large portion of health care budgets (1). Several noninvasive tests are commonly used as gatekeepers to invasive coronary angiography. Despite the frequent use of noninvasive functional stress testing, the prevalence of obstructive coronary artery disease at elective invasive coronary angiography is low (2,3). Coronary CT angiography is an alternative anatomically based imaging modality used to assess coronary artery disease. However, because of its limited positive predictive value, it can lead to increased downstream use of invasive coronary angiography (4-6). Recently, participant-specific coronary CT angiography data have been combined with computational fluid dynamic models, allowing for noninvasive determination of the fractional flow reserve derived from coronary CT angiography (FFR CT). This correlates well with invasive FFR and reduces rates of invasive coronary angiography use compared with coronary CT angiography alone (7,8). In these previous trials,

show abstract

“…Dual-energy CT enables evaluating the myocardial blood supply by mapping iodine distribution within the myocardium. The combined use of CCTA and CT myocardial perfusion imaging can simultaneously assess the anatomical structure and physiological functions of the coronary artery [10][11][12][13][14][15][16][17][18][19][20] (Table 1).…”

Section: Stress Dynamic Ct Myocardial Perfusion Imagingmentioning

confidence: 99%

Advances in Cardiac Computed Tomography Functional Imaging Technology

Tian¹,

Ai-lin²,

Zhou³

et al. 2020

Cardiology

View full text Add to dashboard Cite

Cardiovascular disease (CVD) is the leading cause of death among patients in China, and cardiac computed tomography (CT) is one of the most commonly used examination methods for CVD. Coronary artery CT angiography can be used for the morphologic evaluation of the coronary artery. At present, cardiac CT functional imaging has become an important direction of development of CT. At present, common CT functional imaging technologies include transluminal attenuation gradient, stress dynamic CT myocardial perfusion imaging, and CT-fractional flow reserve. These three imaging modes are introduced and analyzed in this review.

show abstract

Stress Computed Tomography Perfusion Versus Fractional Flow Reserve CT Derived in Suspected Coronary Artery Disease

Cited by 90 publications

References 34 publications

Computed tomographic evaluation of myocardial ischemia

Computed tomographic evaluation of myocardial ischemia

Determinants of Rejection Rate for Coronary CT Angiography Fractional Flow Reserve Analysis

Advances in Cardiac Computed Tomography Functional Imaging Technology

Contact Info

Product

Resources

About