Yuki Tanabe1, Teruhito Kido2, Teruyoshi Uetani3, Akira Kurata2, Tamami Kono3, Akiyoshi Ogimoto3, Masao Miyagawa2, Tsutomu Soma4,5, Kenya Murase6, Hirotaka Iwaki7, Teruhito Mochizuki2. 1. Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan. yuki.tanabe.0225@gmail.com. 2. Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan. 3. Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan. 4. QMS Group, Quality Assurance Department, FUJIFILM RI Pharma Co., Ltd., Tokyo, Japan. 5. Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. 6. Department of Medical Physics and Engineering, Division of Medical Technology and Science, Faculty of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan. 7. Center for Clinical Research Data and Biostatistics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Abstract
OBJECTIVES: To evaluate the feasibility of myocardial blood flow (MBF) by computed tomography from dynamic CT perfusion (CTP) for detecting myocardial ischemia and infarction assessed by cardiac magnetic resonance (CMR) or single-photon emission computed tomography (SPECT). METHODS: Fifty-three patients who underwent stress dynamic CTP and either SPECT (n = 25) or CMR (n = 28) were retrospectively selected. Normal and abnormal perfused myocardium (ischemia/infarction) were assessed by SPECT/CMR using 16-segment model. Sensitivity and specificity of CT-MBF (mL/g/min) for detecting the ischemic/infarction and severe infarction were assessed. RESULTS: The abnormal perfused myocardium and severe infarction were seen in SPECT (n = 90 and n = 19 of 400 segments) and CMR (n = 223 and n = 36 of 448 segments). For detecting the abnormal perfused myocardium, sensitivity and specificity were 80 % (95 %CI, 71-90) and 86 % (95 %CI, 76-91) in SPECT (cut-off MBF, 1.23), and 82 % (95 %CI, 76-88) and 87 % (95 %CI, 80-92) in CMR (cut-off MBF, 1.25). For detecting severe infarction, sensitivity and specificity were 95 % (95 %CI, 52-100) and 72 % (95 %CI, 53-91) in SPECT (cut-off MBF, 0.92), and 78 % (95 %CI, 67-97) and 80 % (95 %CI, 58-86) in CMR (cut-off MBF, 0.98), respectively. CONCLUSIONS: Dynamic CTP has a potential to detect abnormal perfused myocardium and severe infarction assessed by SPECT/CMR using comparable cut-off MBF. KEY POINTS: • CT-MBF accurately reflects the severity of myocardial perfusion abnormality. • CT-MBF provides good diagnostic accuracy for detecting myocardial perfusion abnormalities. • CT-MBF may assist in stratifying severe myocardial infarction in abnormal perfusion myocardium.
OBJECTIVES: To evaluate the feasibility of myocardial blood flow (MBF) by computed tomography from dynamic CT perfusion (CTP) for detecting myocardial ischemia and infarction assessed by cardiac magnetic resonance (CMR) or single-photon emission computed tomography (SPECT). METHODS: Fifty-three patients who underwent stress dynamic CTP and either SPECT (n = 25) or CMR (n = 28) were retrospectively selected. Normal and abnormal perfused myocardium (ischemia/infarction) were assessed by SPECT/CMR using 16-segment model. Sensitivity and specificity of CT-MBF (mL/g/min) for detecting the ischemic/infarction and severe infarction were assessed. RESULTS: The abnormal perfused myocardium and severe infarction were seen in SPECT (n = 90 and n = 19 of 400 segments) and CMR (n = 223 and n = 36 of 448 segments). For detecting the abnormal perfused myocardium, sensitivity and specificity were 80 % (95 %CI, 71-90) and 86 % (95 %CI, 76-91) in SPECT (cut-off MBF, 1.23), and 82 % (95 %CI, 76-88) and 87 % (95 %CI, 80-92) in CMR (cut-off MBF, 1.25). For detecting severe infarction, sensitivity and specificity were 95 % (95 %CI, 52-100) and 72 % (95 %CI, 53-91) in SPECT (cut-off MBF, 0.92), and 78 % (95 %CI, 67-97) and 80 % (95 %CI, 58-86) in CMR (cut-off MBF, 0.98), respectively. CONCLUSIONS: Dynamic CTP has a potential to detect abnormal perfused myocardium and severe infarction assessed by SPECT/CMR using comparable cut-off MBF. KEY POINTS: • CT-MBF accurately reflects the severity of myocardial perfusion abnormality. • CT-MBF provides good diagnostic accuracy for detecting myocardial perfusion abnormalities. • CT-MBF may assist in stratifying severe myocardial infarction in abnormal perfusion myocardium.
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