CT Perfusion: Ready for Prime Time

Overview

Journal Curr Cardiol Rep

Publisher Current Science

Specialty Cardiology & Vascular Diseases

Date 2010 Nov 17

PMID 21080111

Citations 2

Authors

Marietta S Ambrose

Carolina Valdiviezo

Vishal Mehra

Albert C Lardo

Joao A C Lima

Richard T George

Affiliations

Soon will be listed here.

Abstract

Advancements in computed tomography (CT) technology have revolutionized clinical practice, particularly regarding the noninvasive assessment of coronary artery disease (CAD). The versatility of cardiac CT has rendered multiple applications including assessment of cardiac structure and function, myocardial viability, and coronary anatomy. The merits of cardiac computed tomography angiography (CTA) have been proven for the detection, and particularly the exclusion, of CAD. However, CTA becomes limited in the presence of significant CAD. Its inability to consistently identify lesion-associated ischemia may necessitate additional radionuclide myocardial perfusion imaging. Myocardial computed tomography perfusion imaging (CTP) has emerged as a useful and convenient method to immediately assess myocardial ischemia. In this review, we discuss the current state of CTP including available technology, its performance to date from current literature, and future challenges to this field.

Citing Articles

Computed Tomography Perfusion Imaging Detection of Microcirculatory Dysfunction in Small Intestinal Ischemia-Reperfusion Injury in a Porcine Model.

Shi H, Li R, Qiang J, Li Y, Wang L, Sun R PLoS One. 2016; 11(7):e0160102.

PMID: 27458696 PMC: 4961382. DOI: 10.1371/journal.pone.0160102.

Rationale and design of the dual-energy computed tomography for ischemia determination compared to "gold standard" non-invasive and invasive techniques (DECIDE-Gold): A multicenter international efficacy diagnostic study of rest-stress dual-energy....

Truong Q, Knaapen P, Pontone G, Andreini D, Leipsic J, Carrascosa P J Nucl Cardiol. 2015; 22(5):1031-40.

PMID: 25549826 PMC: 4490157. DOI: 10.1007/s12350-014-0035-x.

References

Kurata A, Mochizuki T, Koyama Y, Haraikawa T, Suzuki J, Shigematsu Y . Myocardial perfusion imaging using adenosine triphosphate stress multi-slice spiral computed tomography: alternative to stress myocardial perfusion scintigraphy. Circ J. 2005; 69(5):550-7. DOI: 10.1253/circj.69.550. View

Bamberg F, Klotz E, Flohr T, Becker A, Becker C, Schmidt B . Dynamic myocardial stress perfusion imaging using fast dual-source CT with alternating table positions: initial experience. Eur Radiol. 2010; 20(5):1168-73. DOI: 10.1007/s00330-010-1715-9. View

Mahnken A, Bruners P, Katoh M, Wildberger J, Gunther R, Buecker A . Dynamic multi-section CT imaging in acute myocardial infarction: preliminary animal experience. Eur Radiol. 2005; 16(3):746-52. DOI: 10.1007/s00330-005-0057-5. View

Newhouse J . Fluid compartment distribution of intravenous iothalamate in the dog. Invest Radiol. 1977; 12(4):364-7. DOI: 10.1097/00004424-197707000-00011. View

Hachamovitch R, Hayes S, Friedman J, Cohen I, Berman D . Comparison of the short-term survival benefit associated with revascularization compared with medical therapy in patients with no prior coronary artery disease undergoing stress myocardial perfusion single photon emission computed tomography. Circulation. 2003; 107(23):2900-7. DOI: 10.1161/01.CIR.0000072790.23090.41. View

Ehara M, Kawai M, Surmely J, Matsubara T, Terashima M, Tsuchikane E . Diagnostic accuracy of coronary in-stent restenosis using 64-slice computed tomography: comparison with invasive coronary angiography. J Am Coll Cardiol. 2007; 49(9):951-9. DOI: 10.1016/j.jacc.2006.10.065. View

George R, Arbab-Zadeh A, Miller J, Kitagawa K, Chang H, Bluemke D . Adenosine stress 64- and 256-row detector computed tomography angiography and perfusion imaging: a pilot study evaluating the transmural extent of perfusion abnormalities to predict atherosclerosis causing myocardial ischemia. Circ Cardiovasc Imaging. 2009; 2(3):174-82. PMC: 3035629. DOI: 10.1161/CIRCIMAGING.108.813766. View

Ong T, Chin S, Liew C, Chan W, Seyfarth M, Liew H . Accuracy of 64-row multidetector computed tomography in detecting coronary artery disease in 134 symptomatic patients: influence of calcification. Am Heart J. 2006; 151(6):1323.e1-6. DOI: 10.1016/j.ahj.2005.12.027. View

Schwarz F, Ruzsics B, Schoepf U, Bastarrika G, Chiaramida S, Abro J . Dual-energy CT of the heart--principles and protocols. Eur J Radiol. 2008; 68(3):423-33. DOI: 10.1016/j.ejrad.2008.09.010. View

10.

Okada D, Ghoshhajra B, Blankstein R, Rocha-Filho J, Shturman L, Rogers I . Direct comparison of rest and adenosine stress myocardial perfusion CT with rest and stress SPECT. J Nucl Cardiol. 2009; 17(1):27-37. PMC: 2946891. DOI: 10.1007/s12350-009-9156-z. View

11.

Johnson T, Krauss B, Sedlmair M, Grasruck M, Bruder H, Morhard D . Material differentiation by dual energy CT: initial experience. Eur Radiol. 2006; 17(6):1510-7. DOI: 10.1007/s00330-006-0517-6. View

12.

Di Carli M, Dorbala S, Hachamovitch R . Integrated cardiac PET-CT for the diagnosis and management of CAD. J Nucl Cardiol. 2006; 13(2):139-44. DOI: 10.1007/BF02971234. View

13.

Stewart G . Researches on the Circulation Time and on the Influences which affect it. J Physiol. 1897; 22(3):159-83. PMC: 1512629. DOI: 10.1113/jphysiol.1897.sp000684. View

14.

Di Carli M, Dorbala S, Curillova Z, Kwong R, Goldhaber S, Rybicki F . Relationship between CT coronary angiography and stress perfusion imaging in patients with suspected ischemic heart disease assessed by integrated PET-CT imaging. J Nucl Cardiol. 2007; 14(6):799-809. DOI: 10.1016/j.nuclcard.2007.07.012. View

15.

Blankstein R, Shturman L, Rogers I, Rocha-Filho J, Okada D, Sarwar A . Adenosine-induced stress myocardial perfusion imaging using dual-source cardiac computed tomography. J Am Coll Cardiol. 2009; 54(12):1072-84. DOI: 10.1016/j.jacc.2009.06.014. View

16.

White C, Wright C, Doty D, Hiratza L, Eastham C, Harrison D . Does visual interpretation of the coronary arteriogram predict the physiologic importance of a coronary stenosis?. N Engl J Med. 1984; 310(13):819-24. DOI: 10.1056/NEJM198403293101304. View

17.

Canty Jr J, Judd R, Brody A, Klocke F . First-pass entry of nonionic contrast agent into the myocardial extravascular space. Effects on radiographic estimates of transit time and blood volume. Circulation. 1991; 84(5):2071-8. DOI: 10.1161/01.cir.84.5.2071. View

18.

Wolfkiel C, Ferguson J, Chomka E, Law W, Labin I, Tenzer M . Measurement of myocardial blood flow by ultrafast computed tomography. Circulation. 1987; 76(6):1262-73. DOI: 10.1161/01.cir.76.6.1262. View

19.

Yusuf S, Zucker D, Peduzzi P, Fisher L, Takaro T, Kennedy J . Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomised trials by the Coronary Artery Bypass Graft Surgery Trialists Collaboration. Lancet. 1994; 344(8922):563-70. DOI: 10.1016/s0140-6736(94)91963-1. View

20.

Newhouse J, Murphy Jr R . Tissue distribution of soluble contrast: effect of dose variation and changes with time. AJR Am J Roentgenol. 1981; 136(3):463-7. DOI: 10.2214/ajr.136.3.463. View