Value of multidetector computed tomography evaluation of myocardial perfusion in the assessment of ischemic heart disease: Comparison with nuclear perfusion imaging

Nadjia Kachenoura, Joseph A. Lodato, Tamar Gaspar, Dianna M.E. Bardo, Barbara Newby, Sarah Gips, Nathan Peled, Roberto M. Lang, Victor Mor-Avi*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

MDCT-derived myocardial perfusion has not yet been validated against accepted standards. We developed a technique for quantification of myocardial perfusion from MDCT images and studied its diagnostic value against SPECT myocardial perfusion imaging (MPI). Ninety-eight patients were studied. Abnormal perfusion was detected by comparing normalized segmental x-ray attenuation against values obtained in 20 control subjects. Disagreement with resting MPI was investigated in relationship to MDCT image quality, severity of MPI abnormalities, and stress MPI findings. Resting MPI detected mild or worse abnormalities in 20/78 patients. MDCT detected abnormalities in 15/20 patients (sensitivity of 0.75). Most abnormalities missed by MDCT analysis were graded as mild on MPI. Additional abnormalities found in 16/78 patients were not confirmed on resting MPI (specificity of 0.72). However, 8 of these 16 apparently false positive MDCT perfusion tests had abnormal stress MPI; of these 8 patients, 7 had optimal MDCT image quality, while in 6/8 remaining patients, image quality was suboptimal. When compared with resting MPI, MDCT detected perfusion abnormalities with high accuracy. Moreover, half of MDCT perfusion abnormalities not confirmed by resting MPI were associated with abnormal stress MPI. Importantly, this information can be obtained without additional radiation dose or contrast agent.

Original languageEnglish (US)
Pages (from-to)1897-1905
Number of pages9
JournalEuropean Radiology
Volume19
Issue number8
DOIs
StatePublished - 2009
Externally publishedYes

Keywords

  • Cardiovascular CT
  • Multidetector CT
  • Myocardial perfusion

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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