Sung Mok Kim MD, Presenter: Nothing to Disclose

Seong-Yoon Ryu MD, Abstract Co-Author: Nothing to Disclose

Yoon Ki Cha MD, Abstract Co-Author: Nothing to Disclose

Yeon Hyeon Choe MD, PhD, Abstract Co-Author: Nothing to Disclose

The aim of this study was to compare the diagnostic performance of adenosine-stress dynamic myocardial CT perfusion (CTP) using reduced dynamic scan duration with cardiac magnetic resonance perfusion imaging (MRP) for detection of significant coronary artery stenosis.

This prospective study included 102 symptomatic patients (62  10 years, 77% males) with suspected coronary arteries diseases who underwent adenosine-stress dynamic perfusion imaging using a 128-slice dual-source CT and a 1.5–T MRI. Patients were randomized to dynamic CTP protocols with 30-second (n = 52) or 21-second scan duration (n = 50). Invasive coronary angiography (ICA) was performed after imaging studies. Significant stenosis was considered as ≥ 70% diameter stenosis. All estimates of diagnostic accuracy of perfusion CT and MRI were calculated using ICA as a reference standard.

On a patient-based analysis, the concordance of CTP and MRP interpretations was 86% (κ = 0.72). In each group, the sensitivity and specificity were as follows: CTP (21-second scan duration) – 81% and 94%, MRP – 75% and 94%; CTP (30-second scan duration) – 81% and 86%, MRP – 87% and 86%, respectively. The sensitivity and specificity of CTP and MRP were not significantly different in both protocols. CTP with shorter scan duration resulted in a 23% reduction of radiation dose compared with 30-second scan protocol (4.4 mSv vs. 5.8 mSv, P < 0.001).

Dynamic-stress CTP is comparable to MRP in the detection of significant coronary stenosis (> 70%). CTP with a shorter dynamic scan duration shows similar diagnostic accuracy compared with a standard scan duration technique and reduces radiation dose to patients in dynamic CTP acquisition.

Dynamic CTP with shorter scan duration makes patients easier to take exam and it reduces radiation exposure. This shorten dynamic CTP protocol is recommended for widespread use in the clinical practice.

Kim, S, Ryu, S, Cha, Y, Choe, Y, Adenosine-stress Dynamic Myocardial CT Perfusion Imaging for Detection of Significant Coronary Artery Stenosis: Comparison of a 128-slice Dual-source CT with Reduced Dynamic Scan Duration and 1.5-T MRI.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14017591.html