The dream of a one-stop-shop: Meta-analysis on myocardial perfusion CT

Pelgrim, Gert Jan; Dorrius, Monique D.; Xie, Xueqian; Dekker, Martijn A. M. den; Schoepf, U. Joseph; Henzler, Thomas; Oudkerk, Matthijs; Vliegenthart, Rozemarijn

doi:10.1016/j.ejrad.2014.12.032

Cited by 64 publications

(34 citation statements)

References 57 publications

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“…The largest multicenter study of CT perfusion imaging to date, the CORE320 (Computed tomography angiography and perfusion to assess coronary artery stenosis causing perfusion defects by single photon emission computed tomography) study, used the snapshot approach and demonstrated a sensitivity of 80% and specificity of 74% for the presence of obstructive coronary artery disease compared to single-photon emission computed tomography (SPECT) (63). A recent meta-analysis identified a pooled sensitivity of 75% to 84% and a specificity of 78% to 95%, depending on the protocol used (64). Although CT perfusion involves additional radiation exposure, it may find a useful role as an adjunct to coronary CTA in the presence of indeterminate stenoses.…”

Section: Flow Obstruction and Myocardial Perfusionmentioning

confidence: 99%

Computed Tomography and Cardiac Magnetic Resonance in Ischemic Heart Disease

Dweck

Williams

Moss

et al. 2016

Journal of the American College of Cardiology

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Ischemic heart disease is a complex disease process caused by the development of coronary atherosclerosis, with downstream effects on the left ventricular myocardium. It is characterized by a long preclinical phase, abrupt development of myocardial infarction, and more chronic disease states such as stable angina and ischemic cardiomyopathy. Recent advances in computed tomography (CT) and cardiac magnetic resonance (CMR) now allow detailed imaging of each of these different phases of the disease, potentially allowing ischemic heart disease to be tracked during a patient’s lifetime. In particular, CT has emerged as the noninvasive modality of choice for imaging the coronary arteries, whereas CMR offers detailed assessments of myocardial perfusion, viability, and function. The clinical utility of these techniques is increasingly being supported by robust randomized controlled trial data, although the widespread adoption of cardiac CT and CMR will require further evidence of clinical efficacy and cost effectiveness.

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Section: Flow Obstruction and Myocardial Perfusionmentioning

confidence: 99%

Computed Tomography and Cardiac Magnetic Resonance in Ischemic Heart Disease

Dweck

Williams

Moss

et al. 2016

Journal of the American College of Cardiology

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“…Several studies have since confirmed the feasibility of CT perfusion with CTCA with improved sensitivity and positive predictive value 51–55. In a recent meta-analysis, the diagnostic performance of CT perfusion to detect functionally relevant CAD has shown good sensitivity and specificity against ICA, SPECT and cardiac magnetic resonance (CMR) for the evaluation of haemodynamically relevant CAD 56. CT perfusion may be limited by beam-hardening and motion artefacts and by its lower contrast resolution compared with SPECT or CMR.…”

Section: Applications Of Cctmentioning

confidence: 99%

Cardiac CT: present and future applications

Chahal

Levsky

García

2016

Heart

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“…Pooled results of another recent meta-analysis including 22 articles (1,507 subjects) showed acceptable diagnostic performance for all myocardial perfusion CT techniques (static as well as dynamic) compared to reference standards, including ICA, SPECT, and MRI, with sensitivity ranging from 75% to 89%, and specificity from 78% to 95% (68). It has emerged that static dual-energy and dynamic CTP imaging are associated with a trend towards higher sensitivity than standard static monoenergetic CTP (27).…”

Section: Ctp Imagingmentioning

confidence: 99%

Myocardial blood flow quantification for evaluation of coronary artery disease by computed tomography

Cademartiri

Seitun

Clemente

et al. 2017

Cardiovasc. Diagn. Ther.

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During the last decade coronary computed tomography angiography (CTA) has become the preeminent noninvasive imaging modality to detect coronary artery disease (CAD) with high accuracy.However, CTA has a limited value in assessing the hemodynamic significance of a given stenosis due to a modest specificity and positive predictive value. In recent years, different CT techniques for detecting myocardial ischemia have emerged, such as CT-derived fractional flow reserve (FFR-CT), transluminal attenuation gradient (TAG), and myocardial CT perfusion (CTP) imaging. Myocardial CTP imaging can be performed with a single static scan during first pass of the contrast agent, with monoenergetic or dualenergy acquisition, or as a dynamic, time-resolved scan during stress by using coronary vasodilator agents (adenosine, dipyridamole, or regadenoson). A number of CTP techniques are available, which can assess myocardial perfusion in both a qualitative, semi-quantitative or quantitative manner. Once used primarily as research tools, these modalities are increasingly being used in routine clinical practice. All these techniques offer the substantial advantage of combining anatomical and functional evaluation of flow-limiting coronary stenosis in the same examination that would be beneficial for clinical decision-making. This review focuses on the state-of the-art and future trends of these evolving imaging modalities in the field of cardiology for the physiologic assessments of CAD.

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The dream of a one-stop-shop: Meta-analysis on myocardial perfusion CT

Cited by 64 publications

References 57 publications

Computed Tomography and Cardiac Magnetic Resonance in Ischemic Heart Disease

Computed Tomography and Cardiac Magnetic Resonance in Ischemic Heart Disease

Cardiac CT: present and future applications

Myocardial blood flow quantification for evaluation of coronary artery disease by computed tomography

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