Diagnostic value of quantitative parameters for myocardial perfusion assessment in patients with suspected coronary artery disease by single- and dual-energy computed tomography myocardial perfusion imaging
Ruiz-Muñoz, Aroa (Universitat Autònoma de Barcelona)
Valente, Filipa (Universitat Autònoma de Barcelona)
Dux-Santoy, Lydia (Universitat Autònoma de Barcelona)
Guala, Andrea (Universitat Autònoma de Barcelona)
Teixido-Tura, Gisela (Universitat Autònoma de Barcelona)
Galian-Gay, Laura (Universitat Autònoma de Barcelona)
Gutiérrez García-Moreno, Laura (Universitat Autònoma de Barcelona)
Fernández-Galera, Ruben (Universitat Autònoma de Barcelona)
Casas, Guillem (Universitat Autònoma de Barcelona)
González-Alujas, Teresa (Universitat Autònoma de Barcelona)
Ferreira-Gonzalez, Ignacio (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Evangelista Masip, Arturo (Universitat Autònoma de Barcelona)
Rodríguez-Palomares, José (Universitat Autònoma de Barcelona)

Data:	2021
Resum:	To compare performance of visual and quantitative analyses for detecting myocardial ischaemia from single- and dual-energy computed tomography (CT) in patients with suspected coronary artery disease (CAD). Eighty-four patients with suspected CAD were scheduled for dual-energy cardiac CT at rest (CTA) and pharmacological stress (CTP). Myocardial CT perfusion was analysed visually and using three parameters: mean attenuation density (MA), transmural perfusion ratio (TPR) and myocardial perfusion reserve index (MPRI), on both single-energy CT and CT-based iodine images. Significant CAD was defined in AHA-segments by concomitant myocardial hypoperfusion identified visually or quantitatively (parameter < threshold) and coronary stenosis detected by CTA. Single-photon emission CT and invasive coronary angiography were used as reference. Perfusion-parameter cut-off values were calculated in a randomly-selected subgroup of 30 patients. The best-performing thresholds for TPR, MPRI and MA were 0. 96, 23 and 0. 5 for single-energy CT and 0. 97, 47 and 0. 3 for iodine imaging. For both CT-imaging modalities, TPR yielded the highest area under receiver operating characteristic curve (AUC) (0. 99 and 0. 97 for single-energy CT and iodine imaging, respectively, in vessel-based analysis) compared to visual analysis, MA and MPRI. Visual interpretation on iodine imaging resulted in higher AUC compared to that on single-energy CT in per-vessel (AUC: 0. 93 vs 0. 86, respectively) and per-patient (0. 94 vs 0. 93) analyses. Transmural perfusion ratio on both CT-imaging modalities is the best-performing parameter for detecting myocardial ischaemia compared to visual method and other perfusion parameters. Visual analysis on CT-based iodine imaging outperforms that on single-energy CT.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Coronary artery disease ; Myocardial ischaemia ; CT myocardial perfusion imaging ; Transmural perfusion ratio ; Dual-energy CT-based iodine imaging
Publicat a:	International journal of cardiology. Heart & vasculature, Vol. 32 (february 2021) , ISSN 2352-9067

DOI: 10.1016/j.ijcha.2021.100721
PMID: 33604450

13 p, 2.4 MB

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