Yuki Tanabe, Presenter: Nothing to Disclose

Teruhito Kido MD, PhD, Abstract Co-Author: Nothing to Disclose

Takahiro Yokoi, Abstract Co-Author: Nothing to Disclose

Shintaro Tsuruoka, Abstract Co-Author: Nothing to Disclose

Naoki Fukuyama, Abstract Co-Author: Nothing to Disclose

Takuya Matsuda, Abstract Co-Author: Nothing to Disclose

Rami Yokoyama, Abstract Co-Author: Nothing to Disclose

Masashi Nakamura, Abstract Co-Author: Nothing to Disclose

Yoshiko Nishiyama MD, Abstract Co-Author: Nothing to Disclose

Masao Miyagawa MD, PhD, Abstract Co-Author: Nothing to Disclose

Teruhito Mochizuki MD, Abstract Co-Author: Nothing to Disclose

The aim of this study was to evaluate the feasibility of myocardial blood flow (MBF) index derived from whole heart dynamic myocardial perfusion imaging using 256-slice multi detector row computed tomography (256-slice MDCT) with adenosine triphosphate (ATP) stress.

This study group comprised of 52 patients (mean age 68.7±7.5 years, males, 73.1%) who underwent ATP stress dynamic myocardial CT (CTP) perfusion scans without table movement by using 256-slice MDCT with an 8-cm detector. Moreover, all patients underwent invasive coronary angiography (ICA) (44 patients), single-photon emission CT myocardial perfusion imaging (SPECT-MPI) (20 patients) or cardiac magnetic resonance myocardial perfusion imaging (CMR-MPI) (24 patients). Stress dynamic CTP (whole–heart datasets over 30 consecutive heart beats in systole without spatial and temporal gaps) was acquired with prospective ECG gating (effective radiation dose: 10.6 mSv). MBF index (mL/g/min) was calculated by Patlak plots analysis. Results of the MBF index were compared with the results of ICA, SPECT-MPI or CMR-MPI by receiver operating characteristic (ROC) analysis. Significant stenosis in ICA was defined as more than 75%. SPECT-MPI and CMR-MPI were assessed visually for detecting myocardial ischemia according to the AHA 16segment model.

In all cases, CTP was accomplished without severe side effects. On a vessel-based model, area under the ROC curve (AUC) and the optimal cut-off point (mL/g/min) were 0.841, 1.28 for ICA, 0.852, 1.13 for SPECT-MPI and 0.867,1.28 for CMR-MPI. Sensitivity, specificity, positive and negative predictive values and accuracy were 82.8%, 73.5%, 74.6%, 82.0% and 78.0% for ICA (132 vessels), 75.0%, 90.9%, 75.0%, 90.9% and 86.7% for SPECT-MPI (60 vessels) and 82.9%, 86.5%, 85.3%, 84.2% and 84.7% for CMR-MPI (72 vessels).

Quantitative assessment by MBF index is useful for non-invasive evaluation of the sever coronary artery stenosis and myocardial ischemia.

MBF index derived from dynamic myocardial CT perfusion imaging may enable non invasive, obstructive and precise assessment of coronary artery disease.

Tanabe, Y, Kido, T, Yokoi, T, Tsuruoka, S, Fukuyama, N, Matsuda, T, Yokoyama, R, Nakamura, M, Nishiyama, Y, Miyagawa, M, Mochizuki, T, Diagnostic Performance of Myocardial Blood Flow Index Derived from Dynamic Computed Tomography Perfusion Image: Comparison with Invasive Coronary Angiography, SPECT and Cardiac MR Myocardial Perfusion Image.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006430.html