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Dual-Energy CT Perfusion During Pharmacologic Stress for the Assessment of Myocardial Perfusion Defects Using a Second-Generation Dual-Source CT: A Comparison With Cardiac Magnetic Resonance Imaging

Kim, Sung Mok MD; Chang, Sung-A MD; Shin, Wonseon MD; Choe, Yeon Hyeon MD, PhD

Journal of Computer Assisted Tomography: January/February 2014 - Volume 38 - Issue 1 - p 44–52
doi: 10.1097/RCT.0b013e3182a77626
Cardiovascular Imaging

Objectives This study aimed to assess the diagnostic performance of adenosine-stress dual-energy myocardial computed tomography perfusion (DECTP) imaging using 128-slice dual-source computed tomography (CT) for the detection of myocardial perfusion defects in comparison with stress-perfusion magnetic resonance imaging (MRI).

Methods This prospective study included 50 patients (mean age, 66 [9] years; 64% men) with suspected coronary artery disease who underwent adenosine-stress DECTP using 128-slice dual-source CT as well as adenosine-stress cardiac MRI using a 1.5-T scanner. Estimates of diagnostic accuracy in detecting myocardial perfusion defects were calculatedand compared with those of cardiac MRI.

Results The estimates of diagnostic accuracy in detecting myocardial perfusion defects using DECTP were as follows: sensitivity, 77% (95% confidence interval [CI], 67%–87%); specificity, 94% (95% CI, 92%–95%); positive predictive value, 53% (95% CI, 44%–63%); and negative predictive value, 98% (95% CI, 97%–99%). The results of DECTP imaging were positively correlated with those of cardiac MRI (r = 0.602, P < 0.001). Mean effective radiation doses for stress DECTP imaging and rest coronary CTA were 6.5 (2.2) and 4.9 (1.7) mSv, respectively.

Conclusions Adenosine-stress DECTP imaging enables detection of myocardial ischemia. However, further technical developments are necessary to reduce artifacts and improve the sensitivity of DECTP.

From the *Department of Radiology, †Cardiovascular Imaging Center, and ‡Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; and §Department of Radiology, College of Medicine, Kangwon National University, Chuncheon-Si, Gangwon-Do, Korea.

Received for publication May 1, 2013; accepted July 29, 2013.

Reprints: Yeon Hyeon Choe, MD, Department of Radiology and Cardiovascular Imaging Center, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul 135-710, Korea (e-mail:

This work was supported by IN-SUNG Foundation for Medical Research (CA-98491).

The authors declare no conflict of interest.

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