Abstract
Cardiovascular computed tomography (CT) has undergone significant technical developments over the past decade. The introduction of multi-detector row computed tomography (MDCT) with wider detector coverage, faster gantry rotation speed, multiple X-ray sources, electrocardiographic (ECG)-based tube current modulation, and integration of new iterative reconstruction algorithms has allowed for tangible improvements in diagnostic accuracy. Utilizing these technical advancements, recent attempts have been made to develop CT myocardial perfusion (CTP) imaging strategies. Moreover, the evaluation of myocardial perfusion defects on routine coronary CT angiography (cCTA) has been shown to be of additional value above that of assessing coronary anatomy alone, particularly in the acute chest pain setting. Unfortunately, there are many limitations that currently hinder CT perfusion with single-energy CT imaging, including artifacts. This chapter provides an overview of the role of single-source dual-energy CT in the evaluation of the myocardial perfusion and the current state of Rapid-kVp switching dual-energy CT.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Beckmann EC (2006) CT scanning the early days. Br J Radiol 79(937):5–8
Brian SK et al (2011) CT stress myocardial perfusion imaging using multidetector CT—a review. J Cardiovasc Comput Tomogr 5(6):345–356
Chandra N, Langan DA (2011) Gemstone Detector: dual energy imaging via fast kVp switching. In: Johnson T, Fink C, Schönberg SO, Reiser MF (eds) Dual energy CT in clinical practice, Medical Radiology, Springer, Heidelberg, pp 35–41, ISBN 978-3-642-01739-1. doi:10.1007/174_2010_35, url:http://dx.doi.org/10.1007/174_2010_35
Entrikin DW, Leipsic JA, Carr JJ (2011) Optimization of radiation dose reduction in cardiac computed tomographic angiography. Cardiol Rev 19(4):163–176
Gaemperli O et al (2008) Functionally relevant coronary artery disease: comparison of 64-section CT angiography with myocardial perfusion SPECT. Radiology 248(2):414–423
Goldman LW (2008) Principles of CT: multislice CT. J Nucl Med Technol 36(2):57–68 quiz 75–76
Harvey SH (2009) Is coronary computed tomographic angiography the “gold standard” for coronary artery disease? J Cardiovasc Comput Tomogr 3(5):334–339
Hsiao EM, Rybicki FJ, Steigner M (2010) CT coronary angiography: 256-slice and 320-detector row scanners. Curr Cardiol Rep 12(1):68–75
Johnson TRC et al (2007) Material differentiation by dual energy CT: initial experience. Eur Radiol 17(6):1510–1517
Karcaaltincaba M, Aykut A (2010) Dual-energy CT revisited by multidetector CT: review of principles and clinical applications. Diagn Interv Radiol 17(3):181–194. doi:10.4261/1305-3825.DIR.3860-10.0
Kitagawa K et al (2010) Characterization and correction of beam-hardening artifacts during dynamic volume CT assessment of myocardial perfusion. Radiology 256(1):111–118
Ko JP et al (2012) Dual-energy computed tomography: concepts, performance, and thoracic applications. J Thorac Imaging 27(1):7–22
Matsumoto K et al (2011) Virtual monochromatic spectral imaging with fast kilovoltage switching: improved image quality as compared with that obtained with conventional 120-kVp CT. Radiology 259(1):257–262
Meijboom WB, Van Mieghem CAG et al (2008a) Comprehensive assessment of coronary artery stenoses. J Am Coll Cardiol 52(8):636–643
Meijboom WB, Meijs MFL et al (2008b) Diagnostic accuracy of 64-slice computed tomography coronary angiography. J Antimicrob Chemother 52(25):2135–2144
Melikian N et al (2010) Fractional flow reserve and myocardial perfusion imaging in patients with angiographic multivessel coronary artery disease. JCIN 3(3):307–314
Pijls NH, Fearon WF, Tonino PA, Siebert U, Ikeno F, Bornschein B, van't Veer M, Klauss V, Manoharan G, Engstrøm T, Oldroyd KG, Ver Lee PN, MacCarthy PA, De Bruyne B (2010) Fractional flow reserve versus angiography for guiding percutaneous coronary intervention in patients with multivessel coronary artery disease: 2-year follow-up of the FAME (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) study investigators. J Am Coll Cardiol 56(3):177–84. doi:10.1016/j.jacc.2010.04.012
Rodríguez-Granillo GA, Rosales MA, Degrossi E, Rodriguez AE (2010a) Signal density of left ventricular myocardial segments and impact of beam hardening artifact: implications for myocardial perfusion assessment by multidetector CT coronary angiography. Int J Cardiovasc Imaging 26(3):345–354
Rodríguez-Granillo GA, Ingino CA, Lylyk P (2010b) Myocardial perfusion imaging and infarct characterization using multidetector cardiac computed tomography. World J Cardiol 2(7):198–204
Schuijf JD et al (2011) Current applications and limitations of coronary computed tomography angiography in stable coronary artery disease. Heart 97(4):330–337
Shaw LJ et al (2008) Optimal medical therapy with or without percutaneous coronary intervention to reduce ischemic burden: results from the clinical outcomes utilizing revascularization and aggressive drug evaluation (COURAGE) trial nuclear substudy. Circulation 117(10):1283–1291
Silva AC et al (2011) Dual-energy (spectral) CT: applications in abdominal imaging. Radiographics 31(4):1031–1046 discussion 1047–1050
So A, Lee T-Y (2011) Quantitative myocardial CT perfusion: a pictorial review and the current state of technology development. J Cardiovasc Comput Tomogr 5(6):467–481
So A et al (2009) Beam hardening correction in CT myocardial perfusion measurement. Phys Med Biol 54(10):3031–3050
So A et al (2011) Quantitative myocardial perfusion imaging using rapid kVp switching dual energy CT: preliminary experience. J Cardiovasc Comput Tomogr 5(6):430–442
So A et al (2012) Prospectively ECG triggered rapid kV-switching dual energy CT for quantitative imaging of myocardial perfusion. JACC Cardiovasc Imaging 5(8):829–836. doi:10.1016/j.jcmg.2011.12.026
Tonino PAL et al (2010) Angiographic versus functional severity of coronary artery stenoses in the FAME study. JAC 55(25):2816–2821
Tops LF et al (2008) Noncoronary applications of cardiac multidetector row computed tomography. JACC Cardiovasc Imaging 1(1):94–106
Weininger M et al (2010) Adenosine-stress dynamic real-time myocardial perfusion CT and adenosine-stress first-pass dual-energy myocardial perfusion CT for the assessment of acute chest pain: initial results. Eur J Radiol 81(12):3703-3710. doi:10.1016/j.ejrad.2010.11.022
Wu X, Langan DA, Xu D et al (2009) Monochromatic CT image representation via fast switching dual kVp. Proc SPIE 7258:725845
Zatz LM, Alvarez RE (1977) An inaccuracy incomputed tomography: the energy dependence dependence of CT values. Radiology 124(1):91–97
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Al-Hassan, D.A., Ajlan, A.M., Leipsic, J. (2013). CT Evaluation of the Myocardial Supply-Fast kV-Switching Dual-Energy CT. In: Schoepf, U., Bamberg, F., Ruzsics, B., Vliegenthart, R., Bastarrika, G. (eds) CT Imaging of Myocardial Perfusion and Viability. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2012_791
Download citation
DOI: https://doi.org/10.1007/174_2012_791
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-33878-6
Online ISBN: 978-3-642-33879-3
eBook Packages: MedicineMedicine (R0)