Dynamic myocardial CT perfusion imaging-state of the art.

Content Provider	Europe PMC
Author	Sliwicka, Olga Sechopoulos, Ioannis Baggiano, Andrea Pontone, Gianluca Nijveldt, Robin Habets, Jesse
Abstract	In patients with suspected coronary artery disease (CAD), dynamic myocardial computed tomography perfusion (CTP) imaging combined with coronary CT angiography (CTA) has become a comprehensive diagnostic examination technique resulting in both anatomical and quantitative functional information on myocardial blood flow, and the presence and grading of stenosis. Recently, CTP imaging has been proven to have good diagnostic accuracy for detecting myocardial ischemia, comparable to stress magnetic resonance imaging and positron emission tomography perfusion, while being superior to single photon emission computed tomography. Dynamic CTP accompanied by coronary CTA can serve as a gatekeeper for invasive workup, as it reduces unnecessary diagnostic invasive coronary angiography. Dynamic CTP also has good prognostic value for the prediction of major adverse cardiovascular events. In this article, we will provide an overview of dynamic CTP, including the basics of coronary blood flow physiology, applications and technical aspects including protocols, image acquisition and reconstruction, future perspectives, and scientific challenges.Key Points• Stress dynamic myocardial CT perfusion combined with coronary CTA is a comprehensive diagnostic examination technique resulting in both anatomical and quantitative functional information. • Dynamic CTP imaging has good diagnostic accuracy for detecting myocardial ischemia comparable to stress MRI and PET perfusion. • Dynamic CTP accompanied by coronary CTA may serve as a gatekeeper for invasive workup and can guide treatment in obstructive coronary artery disease. Supplementary InformationThe online version contains supplementary material available at 10.1007/s00330-023-09550-y.
ISSN	09387994
Journal	European Radiology
Volume Number	33
PubMed Central reference number	PMC10326111
Issue Number	8
PubMed reference number	36997751
e-ISSN	14321084
DOI	10.1007/s00330-023-09550-y
Language	English
Publisher	Springer Berlin Heidelberg
Publisher Date	2023-03-30
Publisher Place	Berlin/Heidelberg
Access Restriction	Open
Rights License	Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. © The Author(s) 2023
Subject Keyword	Coronary artery disease Dynamic myocardial computed tomography perfusion Coronary computed tomographic angiography Computed tomography perfusion
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging