AIMS: To evaluate the diagnostic power of integrating the results of computed tomography angiography (CTA) and CT myocardial perfusion (CTP) to identify coronary artery disease (CAD) defined as a flow limiting coronary artery stenosis causing a perfusion defect by single photon emission computed tomography (SPECT). METHODS AND RESULTS: We conducted a multicentre study to evaluate the accuracy of integrated CTA-CTP for the identification of patients with flow-limiting CAD defined by ≥50% stenosis by invasive coronary angiography (ICA) with a corresponding perfusion deficit on stress single photon emission computed tomography (SPECT/MPI). Sixteen centres enroled 381 patients who underwent combined CTA-CTP and SPECT/MPI prior to conventional coronary angiography. All four image modalities were analysed in blinded independent core laboratories. The prevalence of obstructive CAD defined by combined ICA-SPECT/MPI and ICA alone was 38 and 59%, respectively. The patient-based diagnostic accuracy defined by the area under the receiver operating characteristic curve (AUC) of integrated CTA-CTP for detecting or excluding flow-limiting CAD was 0.87 [95% confidence interval (CI): 0.84-0.91]. In patients without prior myocardial infarction, the AUC was 0.90 (95% CI: 0.87-0.94) and in patients without prior CAD the AUC for combined CTA-CTP was 0.93 (95% CI: 0.89-0.97). For the combination of a CTA stenosis ≥50% stenosis and a CTP perfusion deficit, the sensitivity, specificity, positive predictive, and negative predicative values (95% CI) were 80% (72-86), 74% (68-80), 65% (58-72), and 86% (80-90), respectively. For flow-limiting disease defined by ICA-SPECT/MPI, the accuracy of CTA was significantly increased by the addition of CTP at both the patient and vessel levels. CONCLUSIONS: The combination of CTA and perfusion correctly identifies patients with flow limiting CAD defined as ≥50 stenosis by ICA causing a perfusion defect by SPECT/MPI.
AIMS: To evaluate the diagnostic power of integrating the results of computed tomography angiography (CTA) and CT myocardial perfusion (CTP) to identify coronary artery disease (CAD) defined as a flow limiting coronary artery stenosis causing a perfusion defect by single photon emission computed tomography (SPECT). METHODS AND RESULTS: We conducted a multicentre study to evaluate the accuracy of integrated CTA-CTP for the identification of patients with flow-limiting CAD defined by ≥50% stenosis by invasive coronary angiography (ICA) with a corresponding perfusion deficit on stress single photon emission computed tomography (SPECT/MPI). Sixteen centres enroled 381 patients who underwent combined CTA-CTP and SPECT/MPI prior to conventional coronary angiography. All four image modalities were analysed in blinded independent core laboratories. The prevalence of obstructive CAD defined by combined ICA-SPECT/MPI and ICA alone was 38 and 59%, respectively. The patient-based diagnostic accuracy defined by the area under the receiver operating characteristic curve (AUC) of integrated CTA-CTP for detecting or excluding flow-limiting CAD was 0.87 [95% confidence interval (CI): 0.84-0.91]. In patients without prior myocardial infarction, the AUC was 0.90 (95% CI: 0.87-0.94) and in patients without prior CAD the AUC for combined CTA-CTP was 0.93 (95% CI: 0.89-0.97). For the combination of a CTA stenosis ≥50% stenosis and a CTP perfusion deficit, the sensitivity, specificity, positive predictive, and negative predicative values (95% CI) were 80% (72-86), 74% (68-80), 65% (58-72), and 86% (80-90), respectively. For flow-limiting disease defined by ICA-SPECT/MPI, the accuracy of CTA was significantly increased by the addition of CTP at both the patient and vessel levels. CONCLUSIONS: The combination of CTA and perfusion correctly identifies patients with flow limiting CAD defined as ≥50 stenosis by ICA causing a perfusion defect by SPECT/MPI.
Authors: Richard T George; Caterina Silva; Marco A S Cordeiro; Anthony DiPaula; Douglas R Thompson; William F McCarthy; Takashi Ichihara; Joao A C Lima; Albert C Lardo Journal: J Am Coll Cardiol Date: 2006-06-21 Impact factor: 24.094
Authors: Pim A L Tonino; Bernard De Bruyne; Nico H J Pijls; Uwe Siebert; Fumiaki Ikeno; Marcel van' t Veer; Volker Klauss; Ganesh Manoharan; Thomas Engstrøm; Keith G Oldroyd; Peter N Ver Lee; Philip A MacCarthy; William F Fearon Journal: N Engl J Med Date: 2009-01-15 Impact factor: 91.245
Authors: W Bob Meijboom; Matthijs F L Meijs; Joanne D Schuijf; Maarten J Cramer; Nico R Mollet; Carlos A G van Mieghem; Koen Nieman; Jacob M van Werkhoven; Gabija Pundziute; Annick C Weustink; Alexander M de Vos; Francesca Pugliese; Benno Rensing; J Wouter Jukema; Jeroen J Bax; Mathias Prokop; Pieter A Doevendans; Myriam G M Hunink; Gabriel P Krestin; Pim J de Feyter Journal: J Am Coll Cardiol Date: 2008-12-16 Impact factor: 24.094
Authors: Marcelo F Di Carli; Sharmila Dorbala; Zelmira Curillova; Raymond J Kwong; Samuel Z Goldhaber; Frank J Rybicki; Rory Hachamovitch Journal: J Nucl Cardiol Date: 2007-10-22 Impact factor: 5.952
Authors: Marie-Claude Morice; Patrick W Serruys; J Eduardo Sousa; Jean Fajadet; Ernesto Ban Hayashi; Marco Perin; Antonio Colombo; G Schuler; Paul Barragan; Giulio Guagliumi; Ferenc Molnàr; Robert Falotico Journal: N Engl J Med Date: 2002-06-06 Impact factor: 91.245
Authors: Bernhard L Gerber; David A Bluemke; Bennett B Chin; Raymond C Boston; Alan W Heldman; João A C Lima; Dara L Kraitchman Journal: Radiology Date: 2002-10 Impact factor: 11.105
Authors: Julie M Miller; Carlos E Rochitte; Marc Dewey; Armin Arbab-Zadeh; Hiroyuki Niinuma; Ilan Gottlieb; Narinder Paul; Melvin E Clouse; Edward P Shapiro; John Hoe; Albert C Lardo; David E Bush; Albert de Roos; Christopher Cox; Jeffery Brinker; João A C Lima Journal: N Engl J Med Date: 2008-11-27 Impact factor: 91.245
Authors: Oliver Gaemperli; Tiziano Schepis; Ines Valenta; Pascal Koepfli; Lars Husmann; Hans Scheffel; Sebastian Leschka; Franz R Eberli; Thomas F Luscher; Hatem Alkadhi; Philipp A Kaufmann Journal: Radiology Date: 2008-06-13 Impact factor: 11.105
Authors: Satoru Kishi; Tiago A Magalhaes; Richard T George; Marc Dewey; Roger J Laham; Hiroyuki Niinuma; Lisa Aronson Friedman; Christopher Cox; Yutaka Tanami; Joanne D Schuijf; Andrea L Vavere; Kakuya Kitagawa; Marcus Y Chen; Cesar H Nomura; Jeffrey A Brinker; Frank J Rybicki; Marcelo F Di Carli; Armin Arbab-Zadeh; Joao A C Lima Journal: Eur Heart J Cardiovasc Imaging Date: 2014-11-02 Impact factor: 6.875
Authors: Matthias Rief; Marcus Y Chen; Andrea L Vavere; Benjamin Kendziora; Julie M Miller; W Patricia Bandettini; Christopher Cox; Richard T George; João Lima; Marcelo Di Carli; Michail Plotkin; Elke Zimmermann; Michael Laule; Peter Schlattmann; Andrew E Arai; Marc Dewey Journal: Radiology Date: 2017-09-25 Impact factor: 11.105
Authors: Arthur E Stillman; Matthijs Oudkerk; David A Bluemke; Menko Jan de Boer; Jens Bremerich; Ernest V Garcia; Matthias Gutberlet; Pim van der Harst; W Gregory Hundley; Michael Jerosch-Herold; Dirkjan Kuijpers; Raymond Y Kwong; Eike Nagel; Stamatios Lerakis; John Oshinski; Jean-François Paul; Riemer H J A Slart; Vinod Thourani; Rozemarijn Vliegenthart; Bernd J Wintersperger Journal: Int J Cardiovasc Imaging Date: 2018-03-19 Impact factor: 2.357