"Our initial results suggest that for the first time, transferring CT myocardial perfusion imaging from a mere scientific application into a clinical routine might be feasible," presenter Dr. Markus Weininger told AuntMinnie.com.
The group performed myocardial perfusion CT and MRI in 20 consecutive patients (mean age, 69) presenting to the emergency department with acute chest pain.
The patients underwent two protocols. Patients in group 1 received dynamic real-time myocardial perfusion CT using a "shuttle" acquisition mode on a second-generation dual-source CT scanner. Group 2 patients underwent first-pass dual-energy myocardial perfusion CT with the pharmacological stress agent regadenoson. Two experienced readers examined all CT perfusion images, comparing the findings with MRI and SPECT.
Real-time perfusion CT (versus SPECT) showed 86% (85%) sensitivity and 98% (92%) specificity in comparison with perfusion MRI for detecting myocardial perfusion defects. Dual-energy myocardial perfusion CT (versus SPECT) had 94% (94%) sensitivity and 99% (98%) specificity in comparison with MRI.
More segments could be evaluated with dual-energy CT, but the diagnostic performance characteristics of both techniques are similar -- and favorable in comparison with SPECT, Weininger said.
"Compared to our reference standards, MRI and SPECT, dynamic real-time CT myocardial perfusion and dual-energy myocardial perfusion CT showed good agreement for the detection of myocardial perfusion defects," Weininger said. "Our findings may serve to further emphasize the role of CT for integrative imaging of all relevant aspects of CAD with one imaging modality."
