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Springerplus. 2014 Feb 7;3:75. doi: 10.1186/2193-1801-3-75. eCollection 2014.

Adenosine triphosphate stress dual-source computed tomography to identify myocardial ischemia: comparison with invasive coronary angiography.

Author information

1
Department of Radiology, Ehime University, Toon, Japan.
2
Department of Cardiology, Saiseikai Matsuyama Hospital, Matsuyama, Japan.
3
Department of Radiology, Saiseikai Matsuyama Hospital, Matsuyama, Japan.
4
Department of Radiology, Sherbrooke University, Quebec, Canada.
5
Research and Collaboration, Siemens Japan, Tokyo, Japan.

Abstract

PURPOSE:

The purpose of this study was to investigate the utility incremental diagnostic value of combined assessment with coronary CT angiography (CCTA) and myocardial CT perfusion imaging (CTP) using dual-energy technology with an Adenosine Triphosphate (ATP) load technique.

MATERIALS AND METHODS:

Twenty-one patients underwent ATP-provocation dual-energy CT and CAG. We compared the diagnostic accuracy with CAG, for ischemic region due coronary stenosis by CCTA alone and CCTA combined with CTP (Combined CCTA/CTP).

RESULTS:

All of 21 patients CTP images could be evaluated, however 8 CCTA images could not be evaluated by calcification and motion artifact, so assessability was 61.9% (13/21) for CCTA alone, and 100% for Combined CCTA/CTP. With CAG results as a comparison, the sensitivity, specificity, positive predictive value, and negative predictive value were, respectively, 83.3% (20/24), 74.4% (29/39), 66.7% (20/30), and 87.8% (29/33) for CCTA alone, and 66.7% (16/24), 92.3% (36/39), 84.2% (16/19), and 81.8% (36/44) for combined CCTA/CTP. The diagnostic accuracy of the two methods were 77.8% (49/63) and 82.5% (52/63).

CONCLUSION:

Dual-energy CT may be a useful modality for perfusion assessment and correlated well with the severity of stenosis on CAG. This technique may even be of use in cases of severe calcification in the coronary artery wall.

KEYWORDS:

Dual Energy CT; Ischemia; Myocardium; Perfusion CT

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