Hemodynamic significance of coronary stenosis by vessel attenuation measurement on CT compared with adenosine perfusion MRI

Dekker, Martijn A. M. den; Pelgrim, Gert Jan; Pundziūtė, Gabija; Heuvel, Edwin R. van den; Oudkerk, Matthijs; Vliegenthart, Rozemarijn

doi:10.1016/j.ejrad.2014.10.012

Cited by 5 publications

(4 citation statements)

References 30 publications

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“…Considering the fact that invasive FFR was originally validated against SPECT MPI [ 25 ] and that there exists substantial mismatch between invasive FFR and SPECT [ 26 ], the direct comparison between CCO decrease and SPECT MPI extends our understanding of CCO decrease as a clinical tool. The diagnostic accuracy of CCO decrease in the present study is lower than that in the previous studies despite the comparable baseline characteristics [ 15 – 17 ]. Previous studies included substantially smaller study populations [ 15 , 16 ] or used other techniques as a standard of reference (TIMI flow in a previous report [ 17 ] vs. SPECT MPI in the present study).…”

Section: Discussioncontrasting

confidence: 93%

“…The diagnostic accuracy of CCO decrease in the present study is lower than that in the previous studies despite the comparable baseline characteristics [ 15 – 17 ]. Previous studies included substantially smaller study populations [ 15 , 16 ] or used other techniques as a standard of reference (TIMI flow in a previous report [ 17 ] vs. SPECT MPI in the present study). Comparing CCO decrease to PET MPI, the ultimate gold standard for non-invasive assessment of myocardial blood flow has resulted in a diagnostic accuracy of 70% and a cutoff for an abnormal CCO decrease at 0.166 [ 18 ], matching well with the present study.…”

Section: Discussioncontrasting

confidence: 93%

“…Besides static and dynamic CT perfusion [ 12 ], recent studies have suggested that functional relevance of a coronary lesion can be estimated by fractional flow reserve (FFR) derived from CCTA (FFR CT ) with high diagnostic accuracy [ 13 ] and positive impact on downstream resource utilization [ 14 ]. However, since the computation of FFR CT is a cumbersome process with limited availability, faster and less complex alternative CT-derived parameters have evolved, such as the decrease in corrected contrast opacification (CCO) across a stenosis and the transluminal attenuation gradient (TAG) along a coronary vessel [ 15 – 18 ]. Despite the widespread adoption of SPECT MPI into clinical routine and its utility in appropriate clinical decision-making [ 19 , 20 ], none of the previous studies investigating CCO decrease and TAG has used SPECT MPI as the standard of reference.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of coronary opacification derived from coronary computed tomography angiography to detect ischemia: first validation versus single-photon emission computed tomography

et al. 2017

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BackgroundEstimation of functional relevance of a coronary stenosis by fractional flow reserve (FFR) from coronary computed tomography angiography (CCTA) has recently provided encouraging results. Due to its limited availability, the corrected contrast opacification (CCO) decrease and the transluminal attenuation gradient (TAG) were suggested as less complex alternatives. The aim of the present study was to assess the accuracy of CCO decrease and TAG to predict ischemia as assessed by single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI).ResultsThis retrospective study included 72 patients who underwent hybrid CCTA/SPECT MPI with at least one coronary artery stenosis. Of 127 vessels with a coronary stenosis in CCTA, 38 (30%) were causing ischemia in its subtending myocardium. The area under the curve (AUC) for CCO decrease to predict ischemia was 0.707 with sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of 74, 64, 85, 47, and 67%, respectively. For TAG, the AUC was 0.469.ConclusionsCCTA-derived CCO decrease but not TAG predicts ischemia in SPECT MPI. The negative predictive value of CCO decrease of 85% may confer clinical implications in the diagnostic work-up of patients with a coronary stenosis.

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Section: Discussioncontrasting

confidence: 93%

Section: Discussioncontrasting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of coronary opacification derived from coronary computed tomography angiography to detect ischemia: first validation versus single-photon emission computed tomography

et al. 2017

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“…Occlusion of more than 50% of the lumen diameter was defined as stenosis. [17] An aneurysm was defined as a sudden doubling of the arterial cross-section at its largest diameter compared to the arterial diameter in a proximally adjacent section. [18]…”

Section: Methodsmentioning

confidence: 99%

The association between gallstone disease and plaque in the abdominopelvic arteries

et al. 2017

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Background:The aim of this study was to assess the atheromatous plaque, in the abdominopelvic arteries as a marker of cardiac risk in patients with or without gallstone disease (GD).Materials and Methods:A total of 136 patients were enrolled in this cross-sectional study. Forty-eight patients had GD and the remaining 88 patients did not. The presence or absence of gallstones was noted during abdominal ultrasonography while vascular risk factors such as plaque formation, intima-media thickness, plaque calcification, mural thrombus, stenosis, aneurysm, and inflammation were recorded during an abdominopelvic computed tomography scan. In addition, percentage of the abdominopelvic aorta surface covered by atheromatous plaque was calculated.Results:The mean age of patients with GD and without GD was 50.81 ± 16.20 and 50.40 ± 12.43, respectively. Patients with GD were more likely to have diabetes mellitus, a higher body mass index (BMI) (P < 0.001), and higher cholesterol (P < 0.01), and low-density lipoprotein-cholesterol (P < 0.02) levels. No significant differences were found between the groups regarding other atherosclerotic risk factors. Patients with GD had significantly higher rates of the vascular risk factors as intima-media thickness, plaque formation, calcification, aneurysm, mural thrombosis, stenosis, and inflammation in all abdominal arterial segments other than aneurysm in the femoral arteries. In addition, patients with GD had severe atheromatous plaques in the abdominal aorta, common iliac, external iliac, and common femoral artery (CFA). In patients with GD, parameters of age, BMI, and systolic and diastolic blood pressure were all correlated with the severity of the atheromatous plaque in abdominal aorta, common iliac, external iliac, and CFA.Conclusion:We demonstrated a direct relationship between GD and abdominopelvic atheromatous plaque, which is a marker for increased cardiovascular risk, for the first time in the literature. Patients with GD exhibit greater abdominopelvic atherosclerosis and therefore, have a higher risk of cardiovascular disease.

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Corrected coronary opacification decrease from coronary computed tomography angiography: Validation with quantitative 13N-ammonia positron emission tomography

Benz

Gräni

Ferro

et al. 2019

Journal of Nuclear Cardiology

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Hemodynamic significance of coronary stenosis by vessel attenuation measurement on CT compared with adenosine perfusion MRI

Cited by 5 publications

References 30 publications

Diagnostic accuracy of coronary opacification derived from coronary computed tomography angiography to detect ischemia: first validation versus single-photon emission computed tomography

Diagnostic accuracy of coronary opacification derived from coronary computed tomography angiography to detect ischemia: first validation versus single-photon emission computed tomography

The association between gallstone disease and plaque in the abdominopelvic arteries

Corrected coronary opacification decrease from coronary computed tomography angiography: Validation with quantitative 13N-ammonia positron emission tomography

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