Review ArticleTechnical Considerations for Dynamic Myocardial Computed Tomography Perfusion as Part of a Comprehensive Evaluation of Coronary Artery Disease Using Computed TomographyMøller, Mathias B. MD*; Schuijf, Joanne D. PhD†; Oyama-Manabe, Noriko MD, PhD‡; Linde, Jesper J. MD, Phd*; Kühl, Jørgen T. MD, PhD, DMSc*; Lima, Joao A.C. MD, MBA§; Kofoed, Klaus F. MD, PhD, DMSc*,∥,¶ Author Information *Department of Cardiology, Rigshospitalet, University of Copenhagen, The Heart Centre ∥Department of Radiology, Rigshospitalet, University of Copenhagen ¶Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark †Global Research and Development Center, Canon Medical Systems Europe, Zoetermeer, The Netherlands ‡Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan §Departments of Medicine and Radiology, Johns Hopkins Hospital and School of Medicine, Baltimore, MD Mathias B. Møller has received grants from The Research Council of Rigshopitalet anm The Research Council of the Heart Center, Rigshospitalet. Joanne D. Schuijf is an employee of Canon Medical Systems Europe. Noriko Oyama-Manabe has received grants from, Canon Medical Systems Corporation, and from the Japan Society for the Promotion of Science (JSPS) KAKENHI # 26461780, has activities as a consultant for Canon Medical Systems, and received payment for lectures from Daiichi-Sankyo, Philips Medical Systems, Eisai, Bayer Healthcare, GE Healthcare, Nihon Medi-Physics Co. Ltd and Canon Medical Systems. Jørgen T. Kühl has received funding from the Research Council of Rigshospitalet. Jesper J. Linde has received grants from The Danish Research Foundation and The Research Council of Rigshospitalet. Klaus F. Kofoed AP Moller og hustru Chastine McKinney Mollers Fond, The John and Birthe Meyer Foundation, The Danish Agency for Science, Technology and Innovation, The Lundbeck Foundation, GE Healthcare, Canon Medical Systems, The Danish Heart Foundation, The University of Copenhagen, and is on the Speakers Bureau of Canon Medical Systems Corporation. The remaining authors declare no conflicts of interest. Correspondence to: Mathias B. Møller, MD, Department of Cardiology, Rigshospitalet, University of Copenhagen, The Heart Centre, Blegdamsvej 9, Copenhagen 2100, Denmark (e-mail: [email protected]). Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website, www.thoracicimaging.com. Journal of Thoracic Imaging 38(1):p 54-68, January 2023. | DOI: 10.1097/RTI.0000000000000673 Buy SDC Metrics Abstract Dynamic myocardial computed tomography perfusion (DM-CTP) has good diagnostic accuracy for identifying myocardial ischemia as compared with both invasive and noninvasive reference standards. However, DM-CTP has not yet been implemented in the routine clinical examination of patients with suspected or known coronary artery disease. An important hurdle in the clinical dissemination of the method is the development of the DM-CTP acquisition protocol and image analysis. Therefore, the aim of this article is to provide a review of critical parameters in the design and execution of DM-CTP to optimize each step of the examination and avoid common mistakes. We aim to support potential users in the successful implementation and performance of DM-CTP in daily practice. When performed appropriately, DM-CTP may support clinical decision making. In addition, when combined with coronary computed tomography angiography, it has the potential to shorten the time to diagnosis by providing immediate visualization of both coronary atherosclerosis and its functional relevance using one single modality. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.