Diagnostic performance of static single-scan stress perfusion cardiac computed tomography in detecting hemodynamically significant coronary artery stenosis: a comparison with combined invasive coronary angiography and cardiovascular magnetic resonance-myocardial perfusion imaging. (October 2018)

• Record Type: Journal Article
• Authors: Song, Inyoung; Yi, Jeong Geun; Park, Jeong Hee; Kim, Mi Young; Shin, Je Kyoun; Ko, Sung Min
• Is Part Of: Acta radiologica. Volume 59:Number 10(2018:Dec.)
• Page Start: 1184
• Page End: 1193
• Publication Date: 2018-10
• Subjects: Multidetector computed tomography -- magnetic resonance imaging -- coronary angiography -- coronary artery disease -- myocardial perfusion imaging; Radiology, Medical -- Periodicals; Radiography, Medical -- Periodicals; Radiotherapy -- Periodicals; 616.0757
• DOI: 10.1177/0284185117752553
• Languages: English
• ISSNs: 0284-1851

Abstract

Background: Non-invasive anatomical and physiological evaluations of coronary artery disease (CAD) may be obtained with static single-scan stress perfusion cardiac computed tomography (SSPCT). Purpose: To determine the diagnostic performance of static SSPCT for identifying hemodynamically significant CAD. Material and Methods: This prospective study included 29 patients with suspected or known CAD who underwent static SSPCT, cardiovascular magnetic resonance myocardial perfusion imaging (CMR-MPI), and invasive coronary angiography (ICA). CT was performed as follows: (i) coronary calcium scan; (ii) static SSPCT for both coronary artery (coronary CT angiography [CCTA]) and myocardial perfusion (perfusion CT [PCT]) during adenosine infusion; (iii) late-phase scan. The diagnostic performance of CCTA alone, PCT alone, and SSPCT for the detection of a hemodynamically significant CAD (a perfusion defect in a vascular territory subtended by a coronary vessel with ≥ 50% stenosis) was compared with that of combined ICA/CMR-MPI representing the standard of reference. Results: Twenty-three (79%) patients and 47 (54%) vascular territories manifested ischemia-causing coronary stenoses by combined ICA/CMR-MPI. The per-vessel sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curve (AUC) of the SSPCT were 92%, 88%, 90%, 90%, and 0.90, respectively, compared to those of the combined ICA/CMR-MPI. These values for the CCTA alone were 96%, 63%, 75%, 93%, and 0.79, respectively; and the values for the PCT alone were 94%, 83%, 86%, 92%, and 0.88, respectively. The AUC of SSPCT was significantly ( P = 0.013) higher than that of the CCTA alone. Conclusion: Static SSPCT may facilitate detection of hemodynamically significant CAD.