Diagnostic value of quantitative coronary flow reserve and myocardial blood flow estimated by dynamic 320 MDCT scanning in patients with obstructive coronary artery disease

Masahiko Obara, Masanao Naya, Noriko Oyama-Manabe, Tadao Aikawa, Yuuki Tomiyama, Tsukasa Sasaki, Yasuka Kikuchi, Osamu Manabe, Chietsugu Katoh, Nagara Tamaki, Hiroyuki Tsutsui

Research output: Contribution to journalArticle

Abstract

We have developed the method for dynamic 320-row multidetector computed tomography (MDCT)-derived quantitative coronary flow reserve (CFR CT ) and hyperemic myocardial blood flow (MBF CT ). We evaluated diagnostic value of CFR CT and hyperemic MBF CT for detecting obstructive coronary artery disease (CAD) in per-patient and per-vessel analysis, and their relations with the severity of CAD burden. Adenosine stressed and rest dynamic myocardial perfusion MDCT were prospectively performed in patients with known or suspected CAD. Per-patient and per-vessel MBF CT were estimated from dynamic perfusion images in rest and hyperemic phases, and per-patient and per-vessel CFR CT were calculated from the ratio of rest and hyperemic MBF CT . Degree of stenosis was evaluated by coronary CT angiography (CTA) and invasive coronary angiography (ICA). Obstructive stenosis was defined as ≥70% stenosis in ICA. CAD burden with MDCT was calculated by logarithm transformed coronary artery calcium (CAC) score and the CTA-adapted Leaman risk score (CT-LeSc). A logistic regression analysis was used to measure the receiver-operating characteristic curve and corresponding area under the curve (AUC) for the detection of obstructive CAD. Twenty-seven patients and 81 vessels were eligible for this study. Sixteen patients had obstructive CAD, and 31 vessels had obstructive stenosis. Using an optimal cutoff, the CFR CT and hyperemic MBF CT had the moderate diagnostic values in per-patient (AUC=0.89 and 0.86,respectively) and per-vessel (AUC=0.79 and 0.76, respectively). Per-patient CFR CT and hyperemic MBF CT exhibited a moderate inverse correlation with CAC score and the CT-LeSc. Per-patient and per-vessel CFR CT as well as hyperemic MBF CT had moderate diagnostic value for detecting obstructive CAD. These per-patient values exhibited a moderate inverse correlation with CAD burden. CFR CT and hyperemic MBF CT might add quantitative functional information for evaluating patients with CAD.

Original languageEnglish
Article numbere11354
JournalMedicine (United States)
Volume97
Issue number27
DOIs
Publication statusPublished - Jul 1 2018

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Multidetector Computed Tomography
Coronary Artery Disease
Pathologic Constriction
Coronary Angiography
Area Under Curve
Coronary Vessels
Perfusion
Calcium
ROC Curve
Adenosine
Logistic Models
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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Diagnostic value of quantitative coronary flow reserve and myocardial blood flow estimated by dynamic 320 MDCT scanning in patients with obstructive coronary artery disease. / Obara, Masahiko; Naya, Masanao; Oyama-Manabe, Noriko; Aikawa, Tadao; Tomiyama, Yuuki; Sasaki, Tsukasa; Kikuchi, Yasuka; Manabe, Osamu; Katoh, Chietsugu; Tamaki, Nagara; Tsutsui, Hiroyuki.

In: Medicine (United States), Vol. 97, No. 27, e11354, 01.07.2018.

Research output: Contribution to journalArticle

Obara, Masahiko ; Naya, Masanao ; Oyama-Manabe, Noriko ; Aikawa, Tadao ; Tomiyama, Yuuki ; Sasaki, Tsukasa ; Kikuchi, Yasuka ; Manabe, Osamu ; Katoh, Chietsugu ; Tamaki, Nagara ; Tsutsui, Hiroyuki. / Diagnostic value of quantitative coronary flow reserve and myocardial blood flow estimated by dynamic 320 MDCT scanning in patients with obstructive coronary artery disease. In: Medicine (United States). 2018 ; Vol. 97, No. 27.
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abstract = "We have developed the method for dynamic 320-row multidetector computed tomography (MDCT)-derived quantitative coronary flow reserve (CFR CT ) and hyperemic myocardial blood flow (MBF CT ). We evaluated diagnostic value of CFR CT and hyperemic MBF CT for detecting obstructive coronary artery disease (CAD) in per-patient and per-vessel analysis, and their relations with the severity of CAD burden. Adenosine stressed and rest dynamic myocardial perfusion MDCT were prospectively performed in patients with known or suspected CAD. Per-patient and per-vessel MBF CT were estimated from dynamic perfusion images in rest and hyperemic phases, and per-patient and per-vessel CFR CT were calculated from the ratio of rest and hyperemic MBF CT . Degree of stenosis was evaluated by coronary CT angiography (CTA) and invasive coronary angiography (ICA). Obstructive stenosis was defined as ≥70{\%} stenosis in ICA. CAD burden with MDCT was calculated by logarithm transformed coronary artery calcium (CAC) score and the CTA-adapted Leaman risk score (CT-LeSc). A logistic regression analysis was used to measure the receiver-operating characteristic curve and corresponding area under the curve (AUC) for the detection of obstructive CAD. Twenty-seven patients and 81 vessels were eligible for this study. Sixteen patients had obstructive CAD, and 31 vessels had obstructive stenosis. Using an optimal cutoff, the CFR CT and hyperemic MBF CT had the moderate diagnostic values in per-patient (AUC=0.89 and 0.86,respectively) and per-vessel (AUC=0.79 and 0.76, respectively). Per-patient CFR CT and hyperemic MBF CT exhibited a moderate inverse correlation with CAC score and the CT-LeSc. Per-patient and per-vessel CFR CT as well as hyperemic MBF CT had moderate diagnostic value for detecting obstructive CAD. These per-patient values exhibited a moderate inverse correlation with CAD burden. CFR CT and hyperemic MBF CT might add quantitative functional information for evaluating patients with CAD.",
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AU - Aikawa, Tadao

AU - Tomiyama, Yuuki

AU - Sasaki, Tsukasa

AU - Kikuchi, Yasuka

AU - Manabe, Osamu

AU - Katoh, Chietsugu

AU - Tamaki, Nagara

AU - Tsutsui, Hiroyuki

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