Physiologic evaluation of ischemia using cardiac CT: current status of CT myocardial perfusion and CT fractional flow reserve. [Review]

MedStar author(s):
Citation: Journal of cardiovascular computed tomography. 8(4):272-81, 2014 Jul-Aug.PMID: 25151919Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleSubject headings: *Coronary Angiography/mt [Methods] | *Fractional Flow Reserve, Myocardial | *Myocardial Ischemia/ra [Radiography] | *Myocardial Perfusion Imaging/mt [Methods] | *Tomography, X-Ray Computed | Humans | Myocardial Ischemia/pp [Physiopathology] | Predictive Value of Tests | PrognosisYear: 2014ISSN:
  • 1876-861X
Name of journal: Journal of cardiovascular computed tomographyAbstract: Cardiac CT, specifically coronary CT angiography (CTA), is an established technology which detects anatomically significant coronary artery disease with a high sensitivity and negative predictive value compared with invasive coronary angiography. However, the limited ability of CTA to determine the physiologic significance of intermediate coronary stenoses remains a shortcoming compared with other noninvasive methods such as single-photon emission CT, stress echocardiography, and stress cardiac magnetic resonance. Two methods have been investigated recently: (1) myocardial CT perfusion and (2) fractional flow reserve (FFR) computed from CT (FFRCT). Improving diagnostic accuracy by combining the anatomic aspects of coronary CTA with a physiologic assessment via CT perfusion or FFRCT may reduce the need for additional testing to evaluate for ischemia, reduce downstream costs and risks associated with an invasive procedure, and lead to improved patient outcomes. Given a rapidly expanding body of research in this field, this comparative review summarizes the present literature while contrasting the benefits, limitations, and future directions in myocardial CT perfusion and FFRCT imaging. Copyright Published by Elsevier Inc.All authors: Chen MY, Choi AD, Joly JM, Weigold WGFiscal year: FY2015Digital Object Identifier: Date added to catalog: 2015-06-03
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Journal Article MedStar Authors Catalog Article 25151919 Available 25151919

Cardiac CT, specifically coronary CT angiography (CTA), is an established technology which detects anatomically significant coronary artery disease with a high sensitivity and negative predictive value compared with invasive coronary angiography. However, the limited ability of CTA to determine the physiologic significance of intermediate coronary stenoses remains a shortcoming compared with other noninvasive methods such as single-photon emission CT, stress echocardiography, and stress cardiac magnetic resonance. Two methods have been investigated recently: (1) myocardial CT perfusion and (2) fractional flow reserve (FFR) computed from CT (FFRCT). Improving diagnostic accuracy by combining the anatomic aspects of coronary CTA with a physiologic assessment via CT perfusion or FFRCT may reduce the need for additional testing to evaluate for ischemia, reduce downstream costs and risks associated with an invasive procedure, and lead to improved patient outcomes. Given a rapidly expanding body of research in this field, this comparative review summarizes the present literature while contrasting the benefits, limitations, and future directions in myocardial CT perfusion and FFRCT imaging. Copyright Published by Elsevier Inc.

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