Diagnostic performance of dual-energy CT stress myocardial perfusion imaging: direct comparison with cardiovascular MRI
The purpose of this study was to assess the diagnostic performance of stress perfusion dual-energy CT (DECT) and its incremental value when used with coronary CT angiography (CTA) for identifying hemodynamically significant coronary artery disease. One hundred patients with suspected or known corona...
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| Veröffentlicht in: | American journal of roentgenology (1976) 2014-12, Vol.203 (6), p.W605-W613 |
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| container_title | American journal of roentgenology (1976) |
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| creator | Ko, Sung Min Song, Meong Gun Chee, Hyun Kun Hwang, Hweung Kon Feuchtner, Gudrun Maria Min, James K |
| description | The purpose of this study was to assess the diagnostic performance of stress perfusion dual-energy CT (DECT) and its incremental value when used with coronary CT angiography (CTA) for identifying hemodynamically significant coronary artery disease.
One hundred patients with suspected or known coronary artery disease without chronic myocardial infarction detected with coronary CTA underwent stress perfusion DECT, stress cardiovascular perfusion MRI, and invasive coronary angiography (ICA). Stress perfusion DECT and cardiovascular stress perfusion MR images were used for detecting perfusion defects. Coronary CTA and ICA were evaluated in the detection of ≥50% coronary stenosis. The diagnostic performance of coronary CTA for detecting hemo-dynamically significant stenosis was assessed before and after stress perfusion DECT on a per-vessel basis with ICA and cardiovascular stress perfusion MRI as the reference standard.
The performance of stress perfusion DECT compared with cardiovascular stress perfusion MRI on a per-vessel basis in the detection of perfusion defects was sensitivity, 89%; specificity, 74%; positive predictive value, 73%; negative predictive value, 90%. Per segment, these values were sensitivity, 76%; specificity, 80%; positive predictive value, 63%; and negative predictive value, 88%. Compared with ICA and cardiovascular stress perfusion MRI per vessel territory the sensitivity, specificity, positive predictive value, and negative predictive value of coronary CTA were 95%, 61%, 61%, and 95%. The values for stress perfusion DECT were 92%, 72%, 68%, and 94%. The values for coronary CTA and stress perfusion DECT were 88%, 79%, 73%, and 91%. The ROC AUC increased from 0.78 to 0.84 (p=0.02) with the use of coronary CTA and stress perfusion DECT compared with coronary CTA alone.
Stress perfusion DECT plays a complementary role in enhancing the accuracy of coronary CTA for identifying hemodynamically significant coronary stenosis. |
| doi_str_mv | 10.2214/AJR.14.12644 |
| format | Article |
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One hundred patients with suspected or known coronary artery disease without chronic myocardial infarction detected with coronary CTA underwent stress perfusion DECT, stress cardiovascular perfusion MRI, and invasive coronary angiography (ICA). Stress perfusion DECT and cardiovascular stress perfusion MR images were used for detecting perfusion defects. Coronary CTA and ICA were evaluated in the detection of ≥50% coronary stenosis. The diagnostic performance of coronary CTA for detecting hemo-dynamically significant stenosis was assessed before and after stress perfusion DECT on a per-vessel basis with ICA and cardiovascular stress perfusion MRI as the reference standard.
The performance of stress perfusion DECT compared with cardiovascular stress perfusion MRI on a per-vessel basis in the detection of perfusion defects was sensitivity, 89%; specificity, 74%; positive predictive value, 73%; negative predictive value, 90%. Per segment, these values were sensitivity, 76%; specificity, 80%; positive predictive value, 63%; and negative predictive value, 88%. Compared with ICA and cardiovascular stress perfusion MRI per vessel territory the sensitivity, specificity, positive predictive value, and negative predictive value of coronary CTA were 95%, 61%, 61%, and 95%. The values for stress perfusion DECT were 92%, 72%, 68%, and 94%. The values for coronary CTA and stress perfusion DECT were 88%, 79%, 73%, and 91%. The ROC AUC increased from 0.78 to 0.84 (p=0.02) with the use of coronary CTA and stress perfusion DECT compared with coronary CTA alone.
Stress perfusion DECT plays a complementary role in enhancing the accuracy of coronary CTA for identifying hemodynamically significant coronary stenosis.</description><identifier>ISSN: 0361-803X</identifier><identifier>EISSN: 1546-3141</identifier><identifier>DOI: 10.2214/AJR.14.12644</identifier><identifier>PMID: 25415725</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Aged ; Coronary Stenosis - diagnosis ; Exercise Test ; Female ; Humans ; Magnetic Resonance Imaging, Cine - methods ; Male ; Middle Aged ; Myocardial Perfusion Imaging - methods ; Radiography, Dual-Energy Scanned Projection - methods ; Reproducibility of Results ; Sensitivity and Specificity ; Tomography, X-Ray Computed - methods</subject><ispartof>American journal of roentgenology (1976), 2014-12, Vol.203 (6), p.W605-W613</ispartof><rights>American Roentgen Ray Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-f6a27a6d020b697442de9bc908335ef410c0bb36bd6629d25c70f2b7232e6cee3</citedby><cites>FETCH-LOGICAL-c384t-f6a27a6d020b697442de9bc908335ef410c0bb36bd6629d25c70f2b7232e6cee3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,4117,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25415725$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ko, Sung Min</creatorcontrib><creatorcontrib>Song, Meong Gun</creatorcontrib><creatorcontrib>Chee, Hyun Kun</creatorcontrib><creatorcontrib>Hwang, Hweung Kon</creatorcontrib><creatorcontrib>Feuchtner, Gudrun Maria</creatorcontrib><creatorcontrib>Min, James K</creatorcontrib><title>Diagnostic performance of dual-energy CT stress myocardial perfusion imaging: direct comparison with cardiovascular MRI</title><title>American journal of roentgenology (1976)</title><addtitle>AJR Am J Roentgenol</addtitle><description>The purpose of this study was to assess the diagnostic performance of stress perfusion dual-energy CT (DECT) and its incremental value when used with coronary CT angiography (CTA) for identifying hemodynamically significant coronary artery disease.
One hundred patients with suspected or known coronary artery disease without chronic myocardial infarction detected with coronary CTA underwent stress perfusion DECT, stress cardiovascular perfusion MRI, and invasive coronary angiography (ICA). Stress perfusion DECT and cardiovascular stress perfusion MR images were used for detecting perfusion defects. Coronary CTA and ICA were evaluated in the detection of ≥50% coronary stenosis. The diagnostic performance of coronary CTA for detecting hemo-dynamically significant stenosis was assessed before and after stress perfusion DECT on a per-vessel basis with ICA and cardiovascular stress perfusion MRI as the reference standard.
The performance of stress perfusion DECT compared with cardiovascular stress perfusion MRI on a per-vessel basis in the detection of perfusion defects was sensitivity, 89%; specificity, 74%; positive predictive value, 73%; negative predictive value, 90%. Per segment, these values were sensitivity, 76%; specificity, 80%; positive predictive value, 63%; and negative predictive value, 88%. Compared with ICA and cardiovascular stress perfusion MRI per vessel territory the sensitivity, specificity, positive predictive value, and negative predictive value of coronary CTA were 95%, 61%, 61%, and 95%. The values for stress perfusion DECT were 92%, 72%, 68%, and 94%. The values for coronary CTA and stress perfusion DECT were 88%, 79%, 73%, and 91%. The ROC AUC increased from 0.78 to 0.84 (p=0.02) with the use of coronary CTA and stress perfusion DECT compared with coronary CTA alone.
Stress perfusion DECT plays a complementary role in enhancing the accuracy of coronary CTA for identifying hemodynamically significant coronary stenosis.</description><subject>Adult</subject><subject>Aged</subject><subject>Coronary Stenosis - diagnosis</subject><subject>Exercise Test</subject><subject>Female</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging, Cine - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Myocardial Perfusion Imaging - methods</subject><subject>Radiography, Dual-Energy Scanned Projection - methods</subject><subject>Reproducibility of Results</subject><subject>Sensitivity and Specificity</subject><subject>Tomography, X-Ray Computed - methods</subject><issn>0361-803X</issn><issn>1546-3141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkc1P3DAUxK2qqCy0N87Ixx7IYj87dtJDJbR8VlSVEJV6sxznJbhK4sVOQPvfE5YPtac5zO_NG2kIOeBsCcDl8cmPmyWXSw5Kyg9kwXOpMsEl_0gWTCieFUz82SV7Kf1ljOmi1J_ILuSS5xryBXk89bYdQhq9o2uMTYi9HRzS0NB6sl2GA8Z2Q1e3NI0RU6L9Jjgba2-7LT8lHwbqe9v6of1Gax_RjdSFfm2jT7P16Mc7ur0IDza5qbOR_ry5-kx2Gtsl_PKq--T3-dnt6jK7_nVxtTq5zpwo5Jg1yoK2qmbAKlVqKaHGsnIlK4TIsZGcOVZVQlW1UlDWkDvNGqg0CEDlEMU--f6Su56qHmuHwxhtZ9Zxrhw3Jlhv_ncGf2fa8GAkqEIXcg74-hoQw_2EaTS9Tw67zg4YpmS4Aj03A9AzevSCuhhSiti8v-HMPG9l5q3MLNutZvzw32rv8Ns44gnlP5KQ</recordid><startdate>201412</startdate><enddate>201412</enddate><creator>Ko, Sung Min</creator><creator>Song, Meong Gun</creator><creator>Chee, Hyun Kun</creator><creator>Hwang, Hweung Kon</creator><creator>Feuchtner, Gudrun Maria</creator><creator>Min, James K</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201412</creationdate><title>Diagnostic performance of dual-energy CT stress myocardial perfusion imaging: direct comparison with cardiovascular MRI</title><author>Ko, Sung Min ; Song, Meong Gun ; Chee, Hyun Kun ; Hwang, Hweung Kon ; Feuchtner, Gudrun Maria ; Min, James K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-f6a27a6d020b697442de9bc908335ef410c0bb36bd6629d25c70f2b7232e6cee3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Coronary Stenosis - diagnosis</topic><topic>Exercise Test</topic><topic>Female</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging, Cine - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Myocardial Perfusion Imaging - methods</topic><topic>Radiography, Dual-Energy Scanned Projection - methods</topic><topic>Reproducibility of Results</topic><topic>Sensitivity and Specificity</topic><topic>Tomography, X-Ray Computed - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ko, Sung Min</creatorcontrib><creatorcontrib>Song, Meong Gun</creatorcontrib><creatorcontrib>Chee, Hyun Kun</creatorcontrib><creatorcontrib>Hwang, Hweung Kon</creatorcontrib><creatorcontrib>Feuchtner, Gudrun Maria</creatorcontrib><creatorcontrib>Min, James K</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of roentgenology (1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ko, Sung Min</au><au>Song, Meong Gun</au><au>Chee, Hyun Kun</au><au>Hwang, Hweung Kon</au><au>Feuchtner, Gudrun Maria</au><au>Min, James K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic performance of dual-energy CT stress myocardial perfusion imaging: direct comparison with cardiovascular MRI</atitle><jtitle>American journal of roentgenology (1976)</jtitle><addtitle>AJR Am J Roentgenol</addtitle><date>2014-12</date><risdate>2014</risdate><volume>203</volume><issue>6</issue><spage>W605</spage><epage>W613</epage><pages>W605-W613</pages><issn>0361-803X</issn><eissn>1546-3141</eissn><abstract>The purpose of this study was to assess the diagnostic performance of stress perfusion dual-energy CT (DECT) and its incremental value when used with coronary CT angiography (CTA) for identifying hemodynamically significant coronary artery disease.
One hundred patients with suspected or known coronary artery disease without chronic myocardial infarction detected with coronary CTA underwent stress perfusion DECT, stress cardiovascular perfusion MRI, and invasive coronary angiography (ICA). Stress perfusion DECT and cardiovascular stress perfusion MR images were used for detecting perfusion defects. Coronary CTA and ICA were evaluated in the detection of ≥50% coronary stenosis. The diagnostic performance of coronary CTA for detecting hemo-dynamically significant stenosis was assessed before and after stress perfusion DECT on a per-vessel basis with ICA and cardiovascular stress perfusion MRI as the reference standard.
The performance of stress perfusion DECT compared with cardiovascular stress perfusion MRI on a per-vessel basis in the detection of perfusion defects was sensitivity, 89%; specificity, 74%; positive predictive value, 73%; negative predictive value, 90%. Per segment, these values were sensitivity, 76%; specificity, 80%; positive predictive value, 63%; and negative predictive value, 88%. Compared with ICA and cardiovascular stress perfusion MRI per vessel territory the sensitivity, specificity, positive predictive value, and negative predictive value of coronary CTA were 95%, 61%, 61%, and 95%. The values for stress perfusion DECT were 92%, 72%, 68%, and 94%. The values for coronary CTA and stress perfusion DECT were 88%, 79%, 73%, and 91%. The ROC AUC increased from 0.78 to 0.84 (p=0.02) with the use of coronary CTA and stress perfusion DECT compared with coronary CTA alone.
Stress perfusion DECT plays a complementary role in enhancing the accuracy of coronary CTA for identifying hemodynamically significant coronary stenosis.</abstract><cop>United States</cop><pmid>25415725</pmid><doi>10.2214/AJR.14.12644</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Coronary Stenosis - diagnosis Exercise Test Female Humans Magnetic Resonance Imaging, Cine - methods Male Middle Aged Myocardial Perfusion Imaging - methods Radiography, Dual-Energy Scanned Projection - methods Reproducibility of Results Sensitivity and Specificity Tomography, X-Ray Computed - methods |
| title | Diagnostic performance of dual-energy CT stress myocardial perfusion imaging: direct comparison with cardiovascular MRI |
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