Regadenoson-stress myocardial CT perfusion and single-photon emission CT: Rationale, design, and acquisition methods of a prospective, multicenter, multivendor comparison

Cury, Ricardo C.; Kitt, Therese M; Feaheny, Kathleen; Akin, Jamie; George, Richard Т. De

doi:10.1016/j.jcct.2013.09.004

Cited by 13 publications

(12 citation statements)

References 36 publications

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“…Of important note, 5 of the 11 participant sites had limited experience with stress CTP. The study design and methodology have been previously described in detail 23 and are outlined here. The study was conducted in compliance with the principles of the Declaration of Helsinki, International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use, and Good Clinical Practice.…”

Section: Methodsmentioning

confidence: 99%

“…Detailed inclusion and exclusion criteria have been published previously. 23 In summary, the study included symptomatic men aged !45 years and women aged !50 years with a suspicion or known diagnosis of CAD who had been referred for an MPI or cardiac CT procedure. Subjects were excluded if they had renal dysfunction (glomerular filtration rate <45 mL/min), were pregnant or lactating, had history of second-or thirddegree heart block or sinus node dysfunction (unless the subject had a functioning pacemaker), symptomatic hypotension, allergy to study drugs, atrial fibrillation or significant arrhythmias, or contraindications to b-blockers.…”

Section: Subjects and Randomizationmentioning

confidence: 99%

“…All SPECT MPI procedures were performed as previously described 23 and according to the American Society of Nuclear Cardiology guidelines. 24 The rest scan was performed before the stress scan for protocol consistency across the study sites.…”

Section: Spect Imagingmentioning

confidence: 99%

See 2 more Smart Citations

A randomized, multicenter, multivendor study of myocardial perfusion imaging with regadenoson CT perfusion vs single photon emission CT

Cury

Kitt

Feaheny

et al. 2015

Journal of Cardiovascular Computed Tomography

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Section: Methodsmentioning

confidence: 99%

Section: Subjects and Randomizationmentioning

confidence: 99%

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A randomized, multicenter, multivendor study of myocardial perfusion imaging with regadenoson CT perfusion vs single photon emission CT

Cury

Kitt

Feaheny

et al. 2015

Journal of Cardiovascular Computed Tomography

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“…Novel evidence is needed to develop sex-specific profiles of atherosclerotic plaque correlating with perfusion, MBF, fractional flow reserve, CFR, and other physiological measures such as shear stress (142). The emergence of fractional flow reserve computed tomography (143,144) suggests a “game-changing” approach that combines CAD imaging with hemodynamic assessment of plaque; a similar case is being made for coronary CTA with vasodilator perfusion imaging (145,146). Evidence of smaller coronary arteries and higher resting coronary artery flow in women compounds the challenges for CAD imaging and should be addressed.…”

Section: Novel Paradigms and Knowledge Gapsmentioning

confidence: 99%

Noninvasive Imaging to Evaluate Women With Stable Ischemic Heart Disease

Baldassarre

Raman

Min

et al. 2016

JACC: Cardiovascular Imaging

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Declines in cardiovascular deaths have been dramatic for men but occur significantly less in women. Among patients with symptomatic ischemic heart disease (IHD), women experience relatively worse outcomes compared with their male counterparts. Evidence to date has failed to adequately explore unique female imaging targets and their correlative signs and symptoms of IHD as major determinants of IHD risk. We highlight sex-specific anatomic and functional differences in contemporary imaging and introduce imaging approaches that leverage refined targets that may improve IHD risk prediction and identify potential therapeutic strategies for symptomatic women.

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“…Prior studies have reported that CT perfusion imaging can help accurately diagnose CAD compared with various reference standards including single photon emission computed tomography (SPECT), invasive coronary angiography, magnetic resonance (MR) imaging, and fractional flow reserve 8-13 . These encouraging results stimulated the development of a multicenter, multinational trial to test the diagnostic performance of an integrated protocol of coronary angiography and myocardial perfusion by CT in a single exam, to detect stenoses related to perfusion deficits using SPECT-MPI and ICA as the reference 14 .…”

Section: Introductionmentioning

confidence: 99%

Combined coronary angiography and myocardial perfusion by computed tomography in the identification of flow-limiting stenosis – The CORE320 study: An integrated analysis of CT coronary angiography and myocardial perfusion

Magalhães

Kishi

George

et al. 2015

Journal of Cardiovascular Computed Tomography

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Background The combination of coronary computed tomography angiography (CTA) and myocardial CT perfusion (CTP) is gaining increasing acceptance, but a standardized approach to be implemented in the clinical setting is necessary. Objectives To investigate the accuracy of a combined coronary CTA and myocardial CTP comprehensive protocol compared to coronary CTA alone, using a combination of invasive coronary angiography (ICA) and Single-Photon Emission Computed Tomography (SPECT) as reference. Methods Three-hundred eighty-one patients included in CORE320 trial were analyzed in this study. Flow-limiting stenosis was defined as the presence of ≥50% stenosis by ICA with a related perfusion deficit by SPECT. The combined CTA+CTP definition of disease was the presence of a ≥50% stenosis with a related perfusion deficit. All data sets were analyzed by two experienced readers, aligning anatomical findings by CTA with perfusion deficits by CTP. Results Mean patient age was 62±6 years (66% male), 27% with prior history of myocardial infarction. In a per-patient analysis, sensitivity for CTA alone was 93% specificity was 54%, positive predictive value (PPV) was 55%; negative predictive value (NPV) 93% and overall accuracy was 69%. After combining CTA and CTP, sensitivity was 78%, specificity 73%, NPV 64%; PPV 0.85% and overall accuracy was 75%. In a per-vessel analysis, overall accuracy of CTA alone was 73%as compared to 79% for the combination of CTA and CTP (p<0.0001 for difference). Conclusions Combining coronary CTA and myocardial CTP findings through a comprehensive protocol is feasible. While sensitivity is lower, specificity and overall accuracy are higher than assessment by coronary CTA when compared against a reference standard of stenosis with an associated perfusion deficit.

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Regadenoson-stress myocardial CT perfusion and single-photon emission CT: Rationale, design, and acquisition methods of a prospective, multicenter, multivendor comparison

Cited by 13 publications

References 36 publications

A randomized, multicenter, multivendor study of myocardial perfusion imaging with regadenoson CT perfusion vs single photon emission CT

A randomized, multicenter, multivendor study of myocardial perfusion imaging with regadenoson CT perfusion vs single photon emission CT

Noninvasive Imaging to Evaluate Women With Stable Ischemic Heart Disease

Combined coronary angiography and myocardial perfusion by computed tomography in the identification of flow-limiting stenosis – The CORE320 study: An integrated analysis of CT coronary angiography and myocardial perfusion

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