OBJECTIVES: This study sought to determine the feasibility of performing a comprehensive cardiac computed tomographic (CT) examination incorporating stress and rest myocardial perfusion imaging together with coronary computed tomography angiography (CTA). BACKGROUND: Although cardiac CT can identify coronary stenosis, very little data exist on the ability to detect stress-induced myocardial perfusion defects in humans. METHODS: Thirty-four patients who had a nuclear stress test and invasive angiography were included in the study. Dual-source computed tomography (DSCT) was performed as follows: 1) stress CT: contrast-enhanced scan during adenosine infusion; 2) rest CT: contrast-enhanced scan using prospective triggering; and 3) delayed scan: acquired 7 min after rest CT. Images for CTA, computed tomography perfusion (CTP), and single-photon emission computed tomography (SPECT) were each read by 2 independent blinded readers. RESULTS: The DSCT protocol was successfully completed for 33 of 34 subjects (average age 61.4 +/- 10.7 years; 82% male; body mass index 30.4 +/- 5 kg/m(2)) with an average radiation dose of 12.7 mSv. On a per-vessel basis, CTP alone had a sensitivity of 79% and a specificity of 80% for the detection of stenosis > or =50%, whereas SPECT myocardial perfusion imaging had a sensitivity of 67% and a specificity of 83%. For the detection of vessels with > or =50% stenosis with a corresponding SPECT perfusion abnormality, CTP had a sensitivity of 93% and a specificity of 74%. The CTA during adenosine infusion had a per-vessel sensitivity of 96%, specificity of 73%, and negative predictive value of 98% for the detection of stenosis > or =70%. CONCLUSIONS: Adenosine stress CT can identify stress-induced myocardial perfusion defects with diagnostic accuracy comparable to SPECT, with similar radiation dose and with the advantage of providing information on coronary stenosis.
OBJECTIVES: This study sought to determine the feasibility of performing a comprehensive cardiac computed tomographic (CT) examination incorporating stress and rest myocardial perfusion imaging together with coronary computed tomography angiography (CTA). BACKGROUND: Although cardiac CT can identify coronary stenosis, very little data exist on the ability to detect stress-induced myocardial perfusion defects in humans. METHODS: Thirty-four patients who had a nuclear stress test and invasive angiography were included in the study. Dual-source computed tomography (DSCT) was performed as follows: 1) stress CT: contrast-enhanced scan during adenosine infusion; 2) rest CT: contrast-enhanced scan using prospective triggering; and 3) delayed scan: acquired 7 min after rest CT. Images for CTA, computed tomography perfusion (CTP), and single-photon emission computed tomography (SPECT) were each read by 2 independent blinded readers. RESULTS: The DSCT protocol was successfully completed for 33 of 34 subjects (average age 61.4 +/- 10.7 years; 82% male; body mass index 30.4 +/- 5 kg/m(2)) with an average radiation dose of 12.7 mSv. On a per-vessel basis, CTP alone had a sensitivity of 79% and a specificity of 80% for the detection of stenosis > or =50%, whereas SPECT myocardial perfusion imaging had a sensitivity of 67% and a specificity of 83%. For the detection of vessels with > or =50% stenosis with a corresponding SPECT perfusion abnormality, CTP had a sensitivity of 93% and a specificity of 74%. The CTA during adenosine infusion had a per-vessel sensitivity of 96%, specificity of 73%, and negative predictive value of 98% for the detection of stenosis > or =70%. CONCLUSIONS:Adenosine stress CT can identify stress-induced myocardial perfusion defects with diagnostic accuracy comparable to SPECT, with similar radiation dose and with the advantage of providing information on coronary stenosis.
Authors: Joshua L Busch; Adam M Alessio; James H Caldwell; Mohit Gupta; Songshou Mao; Jigar Kadakia; William Shuman; Matthew J Budoff; Kelley R Branch Journal: J Cardiovasc Comput Tomogr Date: 2011-10-24
Authors: Brian B Ghoshhajra; Ian S Rogers; Pal Maurovich-Horvat; Tust Techasith; Daniel Verdini; Manavjot S Sidhu; Nicola K Drzezga; Hector M Medina; Ron Blankstein; Thomas J Brady; Ricardo C Cury Journal: J Cardiovasc Comput Tomogr Date: 2011-10-31
Authors: Andrea L Vavere; Gregory G Simon; Richard T George; Carlos E Rochitte; Andrew E Arai; Julie M Miller; Marcello Di Carli; Armin Arbab-Zadeh; Armin A Zadeh; Marc Dewey; Hiroyuki Niinuma; Roger Laham; Frank J Rybicki; Joanne D Schuijf; Narinder Paul; John Hoe; Sachio Kuribyashi; Hajime Sakuma; Cesar Nomura; Tan Swee Yaw; Klaus F Kofoed; Kunihiro Yoshioka; Melvin E Clouse; Jeffrey Brinker; Christopher Cox; Joao A C Lima Journal: J Cardiovasc Comput Tomogr Date: 2011-11-12
Authors: J Tobias Kühl; Jesper J Linde; Andreas Fuchs; Thomas S Kristensen; Henning Kelbæk; Richard T George; Jens D Hove; Klaus Fuglsang Kofoed Journal: Int J Cardiovasc Imaging Date: 2011-12-06 Impact factor: 2.357