Comprehensive Assessment of Myocardial Perfusion Defects, Regional Wall Motion, and Left Ventricular Function by Using 64-Section Multidetector CT

Cury, Ricardo C.; Nieman, Koen; Shapiro, Michael D.; Butler, Javed; Nomura, César Higa; Ferencik, Maros; Hoffmann, Udo; Abbara, Suhny; Jassal, Davinder S.; Yasuda, Tsunehiro; Gold, Herman K.; Jang, Ik Kyung; Brady, Thomas J.

doi:10.1148/radiol.2482071478

Cited by 157 publications

(107 citation statements)

References 31 publications

Supporting

Mentioning

103

Contrasting

Unclassified

Order By: Relevance

“…Preliminary studies have demonstrated that left and right ventricular volumes measured by CT correlate well with other established modalities (7). However, at the present time, given the limited temporal resolution of cardiac CT and the associated radiation exposure, cardiac CT cannot be recommended as a preferred method for measuring ventricular volumes and ejection fraction if alternative modalities are readily available.…”

Section: Ventricular Functionmentioning

confidence: 95%

The ‘what, when, where, who and how?’ of cardiac computed tomography in 2009: Guidelines for the clinician

Chow

Larose

Bilodeau

et al. 2009

Canadian Journal of Cardiology

Self Cite

View full text Add to dashboard Cite

Section: Ventricular Functionmentioning

confidence: 95%

The ‘what, when, where, who and how?’ of cardiac computed tomography in 2009: Guidelines for the clinician

Chow

Larose

Bilodeau

et al. 2009

Canadian Journal of Cardiology

Self Cite

View full text Add to dashboard Cite

“…Patients with contraindication to CMR (non-compatible pacemakers, defibrillators, or other metal devices) may more easily undergo dedicated CCT studies. CCT is a fast and 24/7 service usually available in emergency context (118), or in clinical daily routine, including the evaluation of coronary arteries and left ventricular function (119).…”

Section: A B and The Assessment Of MI Ischemia And Viability (88)mentioning

confidence: 99%

Infarct characterization using CT

Grutta

Toia

Maffei

et al. 2017

Cardiovasc. Diagn. Ther.

View full text Add to dashboard Cite

Myocardial infarction (MI) is a major cause of death and disability worldwide. The incidence is not expected to diminish, despite better prevention, diagnosis and treatment, because of the ageing population in industrialized countries and unhealthy lifestyles in developing countries. Nowadays it is highly requested an imaging tool able to evaluate MI and viability. Technology improvements determined an expansion of clinical indications from coronary plaque evaluation to functional applications (perfusion, ischemia and viability after MI) integrating additional phases and information in the mainstream examination.Cardiac computed tomography (CCT) and cardiac MR (CMR) employ different contrast media, but may characterize MI with overlapping imaging findings due to the similar kinetics and tissue distribution of gadolinium and iodinated contrast media. CCT may detect first-pass perfusion defects, dynamic perfusion after pharmacological stress, and delayed enhancement (DE) of non-viable territories.

show abstract

“…In 2008 Cury et al [11] validated CT first-pass perfusion imaging under resting conditions combined with wall motion and left ventricular function with SPECT serving as gold standard. Blankstein et al [12] validated CT perfusion imaging under adenosine stress against myocardial SPECT and conventional invasive angiography and found a sensitivity of 79% and specificity of 80% for detection of stenosis >50% by CT perfusion alone on a pervessel-basis.…”

mentioning

confidence: 99%

“…Blankstein et al [12] validated CT perfusion imaging under adenosine stress against myocardial SPECT and conventional invasive angiography and found a sensitivity of 79% and specificity of 80% for detection of stenosis >50% by CT perfusion alone on a pervessel-basis. But, radiation dose matters, and radiation dose using 64-slice CT was high with 13.7±3.4 mSv for single [11] and 9.1±3.9 mSv for dual source CT [12], hence the justification of a second delayed enhancement CT dataacquisition became questionable. Moreover, image noise by CT is significantly higher than CMR [10].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Commentary on: delayed enhancement imaging of myocardial viability: low-dose high-pitch CT versus MRI

Wolf

2011

Eur Radiol

View full text Add to dashboard Cite

In 2005, Nikolaou et al.[1] published a paper in European Radiology about the assessment of myocardial perfusion and viability from routine contrast-enhanced 16-detectorrow computed tomography. The authors reported promising results, however, concluded carefully: "… application of delayed enhancement techniques might be useful. … However, this procedure requires a second delayed CT scan, increasing the radiation exposure of the patient."I remember the first scientific presentations about cardiac perfusion imaging and delayed enhancement using computed tomography-it was interesting, but the scientific community considered this topic more or less a scientific gimmick rather than serious work with clinical relevance. Now, in 2011, Alkadhi et al.[2] publish in European Radiology a paper entitled "Delayed enhancement imaging of myocardial viability: Low-dose high-pitch CT versus MRI." The authors included 24 patients and could show that by using the newest generation CT equipment, delayed enhancement by CT has become a reality at a ultra-low radiation dose in submillisievert range, and is now ready for clinical use: The estimated mean radiation dose was as low as 0.89±0.07 mSv (range: 0.74-1.02 mSv). This low radiation dose was obtained by using the "high-pitch" spiral CT technique with a pitch factor of 3.4 and prospective ECG-synchronization; furthermore a 100 kV tube voltage was applied for the delayed enhancement CT data acquisition, making use of the higher attenuation of iodine at lower photon energies. In the present study, the authors perform a standard contrast-enhanced CTA using a high-pitch protocol on a commercially available 128-slice, dual-source CT system after the administration of 70 ml iodinated contrast media. In order to achieve an adequate dose of iodine, 5 min after the first CT data-acquisition, a second dose of 70 ml of iodinated contrast media was administered and, after a total delay of around 15 min from the first injection, a second high-pitch delayed enhancement CT data-set was obtained. The sensitivity, specificity, and accuracy of CT for the diagnosis of non-viability were 90.0%, 92.9%, and 91.7% per patient and 60.7%, 96.8% and 94.4% per segment, respectively, with MRI serving as the gold standard.What happened in the last 6 years to make the vision of myocardial viability imaging a reality?In my opinion, new technical developments such as lowdose gating techniques, prospective ECG-triggering and high-pitch CT are all responsible for this present step forward in cardiac imaging. The Cardiac Imaging 'hype' started with the introduction of 64-slice CT with a revolution in image quality. This first wave of excitement was followed by a disillusion: the radiation dose of cardiac CT reached values of 12-14 mSv, even higher than the radiation dose values of a conventional invasive angiography. However with the introduction of newer CT equipment with 128-, 256-, and 320-slices, as well as dual source CT-machines, faster CT protocols with radically lower radiation dose have become possible. In ...

show abstract

Comprehensive Assessment of Myocardial Perfusion Defects, Regional Wall Motion, and Left Ventricular Function by Using 64-Section Multidetector CT

Cited by 157 publications

References 31 publications

The ‘what, when, where, who and how?’ of cardiac computed tomography in 2009: Guidelines for the clinician

The ‘what, when, where, who and how?’ of cardiac computed tomography in 2009: Guidelines for the clinician

Infarct characterization using CT

Commentary on: delayed enhancement imaging of myocardial viability: low-dose high-pitch CT versus MRI

Contact Info

Product

Resources

About