Multidetector Computed Tomography Myocardial Perfusion Imaging During Adenosine Stress

George, Richard Т. De; Silva, Caterina; Cordeiro, Marco A. S.; DiPaula, Anthony; Thompson, Douglas; McCarthy, William F.; Ichihara, T.; Lima, João A.C.; Lardo, Albert C.

doi:10.1016/j.jacc.2006.04.014

Cited by 257 publications

(152 citation statements)

References 33 publications

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“…A multicenter study by Jeetley et al (84) demonstrated that myocardial contrast echocardiography with vasodilator stress is comparable to stress SPECT in the detection of CAD. George et al (85) recently determined the accuracy of multislice CT to measure differences in regional myocardial perfusion during stress in a canine model of coronary artery stenosis, and found that stress myocardial perfusion CT provides semiquantitative measurements of altered myocardial perfusion. There are several important points that currently influence the expansion of cardiac MRI in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging for ischemic heart disease

Sakuma

2007

Magnetic Resonance Imaging

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Cardiac MRI has long been recognized as an accurate and reliable means of evaluating cardiac anatomy and ventricular function. Considerable progress has been made in the field of cardiac MRI, and cardiac MRI can provide accurate evaluation of myocardial ischemia and infarction (MI). Late gadolinium (Gd)-enhanced MRI can clearly delineate subendocardial infarction, and the assessment of transmural extent of infarction on late enhanced MRI has been shown to be useful in predicting functional recovery of dysfunctional myocardium in patients after MI. Stress first-pass contrast-enhanced (CE) myocardial perfusion MRI can be used to detect subendocardial ischemia, and recent studies have demonstrated the high diagnostic accuracy of stress myocardial perfusion MRI for detecting significant coronary artery disease (CAD). Free-breathing, whole-heart coronary MR angiography (MRA) was recently introduced as a method that can provide visualization of all three major coronary arteries within a single three-dimensional (3D) acquisition. With further improvements in MRI techniques and the establishment of a standardized study protocol, cardiac MRI will play a pivotal role in managing patients with ischemic heart disease.

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Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging for ischemic heart disease

Sakuma

2007

Magnetic Resonance Imaging

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“…A large number of clinical studies have explored the diagnostic performance of myocardial CTP, showing a good sensitivity and negative predictive value, with modest specificity and positive predictive value (34)(35)(36)(37). Most of these were single center, had small sample size, and used different reference standard modalities including ICA, SPECT, CMR perfusion, and FFR.…”

Section: Clinical Evidencementioning

confidence: 99%

“…George et al were among the first to perform a semi-quantitative assessment of myocardial CTP using SECT (35). By means of a combined definition of ICAderived stenosis ≥50% with a corresponding SPECT perfusion abnormality, in a pilot study, George et al demonstrated that combined CCTA and CTP had a sensitivity, specificity, positive predictive value, and negative predictive value of 86%, 92%, 92%, and 85%, respectively.…”

Section: Clinical Evidencementioning

confidence: 99%

“…Many single and multicenter studies have validated the results of myocardial CTP against other modalities such as SPECT, CMR, PET, invasive coronary angiography (ICA) and invasive fractional flow reserve (FFR) (34)(35)(36)(37)(38)(39)(40)(41)(42). 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.…”

Section: Introductionmentioning

confidence: 99%

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Myocardial CT perfusion imaging for ischemia detection

Carrascosa

Capuñay

2017

Cardiovasc. Diagn. Ther.

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“…Animal studies have shown that myocardial perfusion can be depicted by looking at the differences between rest and stress imaging [16]. Furthermore, dynamic CT data acquisition has been used in attempts to calculate myocardial perfusion reserve.…”

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confidence: 99%

Detection of myocardial perfusion abnormalities: standard dual-source coronary computed tomography angiography versus rest/stress technetium-99m single-photo emission CT

Cheng

Zeng²,

Arellano³

et al. 2010

BJR

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ABSTRACT. We compared coronary dual-source computed tomography angiography (corDSCTA) with technetium-99m single-photon emission computed tomography (SPECT) for the detection of myocardial perfusion abnormalities. Fifty-five consecutive patients underwent both gated myocardial perfusion SPECT and corDSCTA, the latter during a single arterial-phase injection of contrast agent. The perfusion defects visualised by corDSCTA correlated with the findings of rest/stress SPECT. Abnormal findings on stress SPECT, which were due to either ischaemia or infarct, were found in 24 patients. In comparison to SPECT at rest, corDSCTA detected perfusion defects with a sensitivity and specificity of 100% and 78%, respectively. Compared to SPECT at stress, the sensitivity and specificity values of corDSCTA were 83.3% and 90.3%, respectively. On corDSCTA , the average attenuation values of perfusion defects that corresponded to chronic infarcts (28.5¡22.2 HU) were significantly lower (p50.002) than those of non-infarct-related perfusion defects (43.1¡17.5 HU). Using rest/stress SPECT is the gold standard for the diagnosis of myocardial ischaemia, corDSCTA was able to diagnose ischaemic disease (defined as the presence of high-grade stenotic CAD (>50% luminal narrowing)) with a sensitivity and specificity of 59% and 89%, respectively, in patients with no known history of myocardial infarction (n54). Thus, corDSCTA may serve as a diagnostic tool for the detection of perfusion abnormalities (first) visualised by SPECT. There appears to be a limited correlation between coronary stenotic disease and SPECT findings. Coronary artery disease (CAD) is one of the leading causes of morbidity and mortality in developed countries. During the progression of atherosclerosis, the coronary artery wall undergoes pathological changes with build-up of plaque and subsequent luminal narrowing resulting in impaired blood supply to the myocardium. The focus of perfusion imaging is the detection of pathological changes in myocardial perfusion. At present, various perfusion imaging techniques are in clinical use, including nuclear medicine modalities such as single-photon emission computed tomography (SPECT), positron emission tomography (PET) and cardiac perfusion MRI.Rest/stress myocardial perfusion SPECT imaging is a non-invasive modality that is widely used to evaluate patients with suspected CAD. Compared with conventional coronary angiography, myocardial perfusion SPECT has demonstrated sensitivities and specificities of 82-98% and 44-91%, respectively, for the detection of CAD [1,2]. SPECT findings such as the extent, severity and reversibility of perfusion defects have shown to be valuable for the prediction of future cardiovascular events [3]. In the absence of morphological correlation, however, SPECT is limited in allocating perfusion defects to their determining coronary lesion, which is a major precondition for accurate therapy planning [4]. As a consequence, invasive conventional coronary angiography (CCA) is often performed in cases of abnorma...

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Multidetector Computed Tomography Myocardial Perfusion Imaging During Adenosine Stress

Abstract: Adenosine-augmented MDCT myocardial perfusion imaging provides semiquantitative measurements of myocardial perfusion during first-pass MDCT imaging in a canine model of LAD stenosis.

Cited by 257 publications

References 33 publications

Magnetic resonance imaging for ischemic heart disease

Magnetic resonance imaging for ischemic heart disease

Myocardial CT perfusion imaging for ischemia detection

Detection of myocardial perfusion abnormalities: standard dual-source coronary computed tomography angiography versus rest/stress technetium-99m single-photo emission CT

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