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State-of-the-Art Updates on Cardiac Computed Tomographic Angiography for Assessing Coronary Artery Disease

  • Imaging (J Hung, Section Editor)
  • Published:
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Opinion statement

Cardiac computed tomographic angiography (CCTA) is a noninvasive imaging modality that is increasingly useful for the evaluation of coronary artery disease (CAD). Over the past decade, CCTA has consistently demonstrated an excellent sensitivity for the detection and exclusion of coronary atherosclerosis in patients with stable or acute chest pain symptoms. Large prospective registries have repeatedly demonstrated the prognostic significance of the presence, extent, or absence of CAD by CCTA. In response to initial concerns, technical advances have permitted a dramatic reduction in patient radiation exposure with preserved image quality. For many patients, the radiation dose of CCTA is less than half of that with conventional myocardial perfusion imaging while providing significantly more anatomic information. Furthermore, CCTA’s excellent spatial resolution is increasingly being used for noninvasive assessment of coronary plaque, including the detection of higher-risk vulnerable plaque and association between plaque characteristics and ischemia. Finally, new promising techniques that incorporate physiology with anatomy, such as CT-based fractional flow reserve (FFR-CT) and CT perfusion (CTP), are allowing for the noninvasive hemodynamic assessment of coronary stenoses and improvements in the specificity of CCTA findings. Such advances augur a coming transition when CCTA will be a first-line test for the detection, exclusion, and even management of CAD in many patients.

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References and Recommended Reading

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  1. Taylor AJ, Cerqueira M, Hodgson JM, et al. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography. J Am Coll Cardiol. 2010;56:1864–94.

    Article  PubMed  Google Scholar 

  2. Wolk MJ, Bailey SR, Doherty JU, et al. ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease. J Am Coll Cardiol. 2014;63:380–406.

  3. Diamond GA, Forrester JS. Analysis of probability as an aid in the clinical diagnosis of coronary-artery disease. N Engl J Med. 1979;300:1350–8.

    Article  CAS  PubMed  Google Scholar 

  4. Goff DC, Lloyd-Jones DM, Bennett G, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;63:2935–59.

    Article  PubMed  Google Scholar 

  5. Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129:S1–45.

    Article  PubMed  Google Scholar 

  6. Budoff MJ, Dowe D, Jollis JG, et al. Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial. J Am Coll Cardiol. 2008;52:1724–32.

    Article  PubMed  Google Scholar 

  7. Paech DC, Weston AR. A systematic review of the clinical effectiveness of 64-slice or higher computed tomography angiography as an alternative to invasive coronary angiography in the investigation of suspected coronary artery disease. BMC Cardiovasc Disord. 2011;11:32.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Meijboom WB, Meijs MF, Schuijf JD, et al. Diagnostic accuracy of 64-slice computed tomography coronary angiography: a prospective, multicenter, multivendor study. J Am Coll Cardiol. 2008;52:2135–44.

    Article  PubMed  Google Scholar 

  9. Hulten EA, Carbonaro S, Petrillo SP, Mitchell JD, Villines TC. Prognostic value of cardiac computed tomography angiography: a systematic review and meta-analysis. J Am Coll Cardiol. 2011;57:1237–47.

    Article  PubMed  Google Scholar 

  10. Min JK, Dunning A, Lin FY, et al. Age- and sex-related differences in all-cause mortality risk based on coronary computed tomography angiography findings results from the International Multicenter CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry) of 23,854 patients without known coronary artery disease. J Am Coll Cardiol. 2011;58:849–60.

    Article  PubMed  Google Scholar 

  11. Lin FY, Shaw LJ, Dunning AM, et al. Mortality risk in symptomatic patients with nonobstructive coronary artery disease: a prospective 2-center study of 2,583 patients undergoing 64-detector row coronary computed tomographic angiography. J Am Coll Cardiol. 2011;58:510–9.

    Article  PubMed  Google Scholar 

  12. Nakazato R, Arsanjani R, Achenbach S, et al. Age-related risk of major adverse cardiac event risk and coronary artery disease extent and severity by coronary CT angiography: results from 15 187 patients from the International Multisite CONFIRM Study. Eur Heart J Cardiovasc Imaging. 2014;15:586–94.

    Article  PubMed Central  PubMed  Google Scholar 

  13. investigators S-H. CT coronary angiography in patients with suspected angina due to coronary heart disease (SCOT-HEART): an open-label, parallel-group, multicentre trial. Lancet. 2015.Demonstrated that CCTA is useful in improving diagnostic certainty in outpatients presenting with stable angina syndromes.

  14. Douglas PS, Hoffmann U, Patel MR, et al. Outcomes of anatomical versus functional testing for coronary artery disease. N Engl J Med. 2015.Demonstrated no significant difference in short-term clinical outcomes when using a strategy of CCTA versus functional imaging in patients with suspected CAD.

  15. Montalescot G, Sechtem U, Achenbach S, et al. 2013 ESC guidelines on the management of stable coronary artery disease: the task force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J. 2013;34:2949–3003.

    Article  PubMed  Google Scholar 

  16. Cho I, Chang H-J, Sung JM, et al. Coronary computed tomographic angiography and risk of all-cause mortality and nonfatal myocardial infarction in subjects without chest pain syndrome from the CONFIRM Registry (coronary CT angiography evaluation for clinical outcomes: an international multicenter registry). Circulation. 2012;126:304–13.

    Article  PubMed  Google Scholar 

  17. Cho I, Chang HJ, Ó Hartaigh B, et al. Incremental prognostic utility of coronary CT angiography for asymptomatic patients based upon extent and severity of coronary artery calcium: results from the COronary CT Angiography EvaluatioN For Clinical Outcomes InteRnational Multicenter (CONFIRM) Study. Eur Heart J. 2015;36:501–8.

    Article  PubMed  Google Scholar 

  18. Al-Mallah MH, Qureshi W, Lin FY, et al. Does coronary CT angiography improve risk stratification over coronary calcium scoring in symptomatic patients with suspected coronary artery disease? Results from the prospective multicenter international CONFIRM registry. Eur Heart J Cardiovasc Imaging. 2014;15:267–74.

    Article  PubMed  Google Scholar 

  19. Min JK, Labounty TM, Gomez MJ, et al. Incremental prognostic value of coronary computed tomographic angiography over coronary artery calcium score for risk prediction of major adverse cardiac events in asymptomatic diabetic individuals. Atherosclerosis. 2014;232:298–304.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Muhlestein JB, Lappe DL, Lima JA, et al. Effect of screening for coronary artery disease using CT angiography on mortality and cardiac events in high-risk patients with diabetes: the FACTOR-64 randomized clinical trial. JAMA. 2014;312:2234–43. Demonstrated no significant difference in four year clinical outcomes in asymptomatic diabetics randomized to CCTA or optimal medical care.

    Article  CAS  PubMed  Google Scholar 

  21. Gibbons RJ. Optimal medical therapy vs CT angiography screening for patients with diabetes. JAMA. 2014;312:2219–20.

    Article  CAS  PubMed  Google Scholar 

  22. Raff GL, Chinnaiyan KM, Cury RC, et al. SCCT guidelines on the use of coronary computed tomographic angiography for patients presenting with acute chest pain to the emergency department: a report of the Society of Cardiovascular Computed Tomography Guidelines Committee. J Cardiovasc Comput Tomogr. 2014;8:254–71.

    Article  PubMed  Google Scholar 

  23. Litt HI, Gatsonis C, Snyder B, et al. CT angiography for safe discharge of patients with possible acute coronary syndromes. N Engl J Med. 2012;366:1393–403. Demonstrated that use of CCTA in acute chest pain in low risk patients leads to decreased emergency room length of stay.

    Article  CAS  PubMed  Google Scholar 

  24. Hoffmann U, Truong QA, Schoenfeld DA, et al. Coronary CT angiography versus standard evaluation in acute chest pain. N Engl J Med. 2012;367:299–308.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  25. Truong QA, Hayden D, Woodard PK, et al. Sex differences in the effectiveness of early coronary computed tomographic angiography compared with standard emergency department evaluation for acute chest pain: the rule-out myocardial infarction with Computer-Assisted Tomography (ROMICAT)-II Trial. Circulation. 2013;127:2494–502.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Becker MC, Galla JM, Nissen SE. LEft main trunk coronary artery dissection as a consequence of inaccurate coronary computed tomographic angiography. Arch Intern Med. 2011;171:698–701.

    PubMed  Google Scholar 

  27. Redberg RF. Coronary CT, angiography for acute chest pain. N Engl J Med. 2012;367:375–6.

    Article  CAS  PubMed  Google Scholar 

  28. Hulten E, Pickett C, Bittencourt MS, et al. Outcomes after coronary computed tomography angiography in the emergency department: a systematic review and meta-analysis of randomized, controlled trials. J Am Coll Cardiol. 2013;61:880–92.

    Article  PubMed  Google Scholar 

  29. Poon M, Cortegiano M, Abramowicz AJ, et al. Associations between routine coronary computed tomographic angiography and reduced unnecessary hospital admissions, length of stay, recidivism rates, and invasive coronary angiography in the emergency department triage of chest pain. J Am Coll Cardiol. 2013;62:543–52.

    Article  PubMed  Google Scholar 

  30. Raff GL, Abidov A, Achenbach S, et al. SCCT guidelines for the interpretation and reporting of coronary computed tomographic angiography. J Cardiovasc Comput Tomogr. 2009;3:122–36.

    Article  PubMed  Google Scholar 

  31. Einstein AJ, Berman DS, Min JK, et al. Patient-centered imaging: shared decision making for cardiac imaging procedures with exposure to ionizing radiation. J Am Coll Cardiol. 2014;63:1480–9.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Halliburton SS, Abbara S, Chen MY, et al. SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT. J Cardiovasc Comput Tomogr. 2011;5:198–224.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Buechel RR, Husmann L, Herzog BA, et al. Low-dose computed tomography coronary angiography with prospective electrocardiogram triggering: feasibility in a large population. J Am Coll Cardiol. 2011;57:332–6.

    Article  PubMed  Google Scholar 

  34. Bischoff B, Hein F, Meyer T, et al. Impact of a reduced tube voltage on CT angiography and radiation dose: results of the PROTECTION I study. JACC Cardiovasc Imaging. 2009;2:940–6.

    Article  PubMed  Google Scholar 

  35. Hausleiter J, Meyer T, Hadamitzky M, et al. Radiation dose estimates from cardiac multislice computed tomography in daily practice: impact of different scanning protocols on effective dose estimates. Circulation. 2006;113:1305–10.

    Article  PubMed  Google Scholar 

  36. Fuchs TA, Stehli J, Bull S, et al. Coronary computed tomography angiography with model-based iterative reconstruction using a radiation exposure similar to chest X-ray examination. Eur Heart J. 2014;35:1131–6.

    Article  PubMed Central  PubMed  Google Scholar 

  37. Stehli J, Fuchs TA, Bull S, et al. Accuracy of coronary CT angiography using a submillisievert fraction of radiation exposure: comparison with invasive coronary angiography. J Am Coll Cardiol. 2014;64:772–80.

    Article  PubMed  Google Scholar 

  38. Schoenhagen P, Baker ME. Our preoccupation with ultra-low dose radiation exposure. Low contrast resolution and cardiovascular CT imaging. J Cardiovasc Comput Tomogr. 2014;8:426–8.

    Article  PubMed  Google Scholar 

  39. Achenbach S, Marwan M, Ropers D, et al. Coronary computed tomography angiography with a consistent dose below 1 mSv using prospectively electrocardiogram-triggered high-pitch spiral acquisition. Eur Heart J. 2010;31:340–6.

    Article  PubMed  Google Scholar 

  40. Achenbach S, Goroll T, Seltmann M, et al. Detection of coronary artery stenoses by low-dose, prospectively ECG-triggered, high-pitch spiral coronary CT angiography. JACC Cardiovasc Imaging. 2011;4:328–37.

    Article  PubMed  Google Scholar 

  41. Ghadri JR, Kuest SM, Goetti R, et al. Image quality and radiation dose comparison of prospectively triggered low-dose CCTA: 128-slice dual-source high-pitch spiral versus 64-slice single-source sequential acquisition. Int J Cardiovasc Imaging. 2012;28:1217–25.

    Article  PubMed  Google Scholar 

  42. Xu L, Yang L, Zhang Z, et al. Low-dose adaptive sequential scan for dual-source CT coronary angiography in patients with high heart rate: comparison with retrospective ECG gating. Eur J Radiol. 2010;76:183–7.

    Article  PubMed  Google Scholar 

  43. Lee AM, Engel LC, Shah B, et al. Coronary computed tomography angiography during arrhythmia: Radiation dose reduction with prospectively ECG-triggered axial and retrospectively ECG-gated helical 128-slice dual-source CT. J Cardiovasc Comput Tomogr. 2012;6:172–83.

    Article  PubMed  Google Scholar 

  44. Xu L, Yang L, Zhang Z, et al. Prospectively ECG-triggered sequential dual-source coronary CT angiography in patients with atrial fibrillation: comparison with retrospectively ECG-gated helical CT. Eur Radiol. 2013;23:1822–8.

    Article  PubMed  Google Scholar 

  45. Srichai MB, Barreto M, Lim RP, Donnino R, Babb JS, Jacobs JE. Prospective-triggered sequential dual-source end-systolic coronary CT angiography for patients with atrial fibrillation: a feasibility study. J Cardiovasc Comput Tomogr. 2013;7:102–9.

    Article  PubMed  Google Scholar 

  46. Techasith T, Ghoshhajra BB, Truong QA, et al. The effect of heart rhythm on patient radiation dose with dual-source cardiac computed tomography. J Cardiovasc Comput Tomogr. 2011;5:255–63.

    Article  PubMed  Google Scholar 

  47. Fischer C, Hulten E, Belur P, Smith R, Voros S, Villines TC. Coronary CT angiography versus intravascular ultrasound for estimation of coronary stenosis and atherosclerotic plaque burden: a meta-analysis. J Cardiovasc Comput Tomogr. 2013;7:256–66.

    Article  PubMed  Google Scholar 

  48. Boogers MJ, Broersen A, van Velzen JE, et al. Automated quantification of coronary plaque with computed tomography: comparison with intravascular ultrasound using a dedicated registration algorithm for fusion-based quantification. Eur Heart J. 2012;33:1007–16.

    Article  PubMed  Google Scholar 

  49. Versteylen MO, Kietselaer BL, Dagnelie PC, et al. Additive value of semiautomated quantification of coronary artery disease using cardiac computed tomographic angiography to predict future acute coronary syndrome. J Am Coll Cardiol. 2013;61:2296–305.

    Article  PubMed  Google Scholar 

  50. Motoyama S, Sarai M, Harigaya H, et al. Computed tomographic angiography characteristics of atherosclerotic plaques subsequently resulting in acute coronary syndrome. J Am Coll Cardiol. 2009;54:49–57.

    Article  PubMed  Google Scholar 

  51. Motoyama S, Kondo T, Sarai M, et al. Multislice computed tomographic characteristics of coronary lesions in acute coronary syndromes. J Am Coll Cardiol. 2007;50:319–26.

    Article  PubMed  Google Scholar 

  52. Maurovich-Horvat P, Hoffmann U, Vorpahl M, Nakano M, Virmani R, Alkadhi H. The napkin-ring sign: CT signature of high-risk coronary plaques? JACC Cardiovasc Imaging. 2010;3:440–4.

    Article  PubMed  Google Scholar 

  53. Maurovich-Horvat P, Schlett CL, Alkadhi H, et al. The napkin-ring sign indicates advanced atherosclerotic lesions in coronary CT angiography. JACC Cardiovasc Imaging. 2012;5:1243–52.

    Article  PubMed  Google Scholar 

  54. Otsuka K, Fukuda S, Tanaka A, et al. Napkin-ring sign on coronary CT angiography for the prediction of acute coronary syndrome. JACC Cardiovasc Imaging. 2013;6:448–57.

    Article  PubMed  Google Scholar 

  55. Puchner SB, Liu T, Mayrhofer T, et al. High-risk plaque detected on coronary CT angiography predicts acute coronary syndromes independent of significant stenosis in acute chest pain: results from the ROMICAT-II trial. J Am Coll Cardiol. 2014;64:684–92.

    Article  PubMed  Google Scholar 

  56. Dey D, Schuhbaeck A, Min JK, Berman DS, Achenbach S. Non-invasive measurement of coronary plaque from coronary CT angiography and its clinical implications. Expert Rev Cardiovasc Ther. 2013;11:1067–77.

    Article  CAS  PubMed  Google Scholar 

  57. Nakazato R, Shalev A, Doh JH, et al. Aggregate plaque volume by coronary computed tomography angiography is superior and incremental to luminal narrowing for diagnosis of ischemic lesions of intermediate stenosis severity. J Am Coll Cardiol. 2013;62:460–7.

    Article  PubMed  Google Scholar 

  58. Park HB, Heo R, ó Hartaigh B, et al. Atherosclerotic plaque characteristics by CT angiography identify coronary lesions that cause ischemia: a direct comparison to fractional flow reserve. JACC Cardiovasc Imaging. 2015;8:1–10.

    Article  CAS  PubMed  Google Scholar 

  59. Zeb I, Li D, Nasir K, et al. Effect of statin treatment on coronary plaque progression—a serial coronary CT angiography study. Atherosclerosis. 2013;231:198–204.

    Article  CAS  PubMed  Google Scholar 

  60. Nakazato R, Gransar H, Berman DS, et al. Statins use and coronary artery plaque composition: results from the International Multicenter CONFIRM Registry. Atherosclerosis. 2012;225:148–53.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  61. Korosoglou G, Katus HA. Quantification of atherosclerotic coronary plaque: the missing link between elevated biochemical markers and adverse outcomes in the “vulnerable” patient? J Am Coll Cardiol. 2013;62:1815–6.

    Article  PubMed  Google Scholar 

  62. Muller O, Mangiacapra F, Ntalianis A, et al. Long-term follow-up after fractional flow reserve-guided treatment strategy in patients with an isolated proximal left anterior descending coronary artery stenosis. JACC Cardiovasc Interv. 2011;4:1175–82.

    Article  PubMed  Google Scholar 

  63. De Bruyne B, Fearon WF, Pijls NH, et al. Fractional flow reserve-guided PCI for stable coronary artery disease. N Engl J Med. 2014;371:1208–17. Demonstrated the diagnostic accuracy of FFR-CT compared to invasive FFR.

    Article  PubMed  Google Scholar 

  64. Taylor CA, Fonte TA, Min JK. Computational fluid dynamics applied to cardiac computed tomography for noninvasive quantification of fractional flow reserve: scientific basis. J Am Coll Cardiol. 2013;61:2233–41.

    Article  PubMed  Google Scholar 

  65. Norgaard BL, Leipsic J, Gaur S, et al. Diagnostic performance of noninvasive fractional flow reserve derived from coronary computed tomography angiography in suspected coronary artery disease: the NXT trial (Analysis of Coronary Blood Flow Using CT Angiography: Next Steps). J Am Coll Cardiol. 2014;63:1145–55.

    Article  PubMed  Google Scholar 

  66. Koo BK, Erglis A, Doh JH, et al. Diagnosis of ischemia-causing coronary stenoses by noninvasive fractional flow reserve computed from coronary computed tomographic angiograms. Results from the prospective multicenter DISCOVER-FLOW (Diagnosis of Ischemia-Causing Stenoses Obtained Via Noninvasive Fractional Flow Reserve) study. J Am Coll Cardiol. 2011;58:1989–97.

    Article  PubMed  Google Scholar 

  67. Min JK, Leipsic J, Pencina MJ, et al. Diagnostic accuracy of fractional flow reserve from anatomic CT angiography. JAMA. 2012;308:1237–45.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  68. Hecht HS. The game changer? J Am Coll Cardiol. 2014;63:1156–8.

    Article  PubMed  Google Scholar 

  69. Kim KH, Doh JH, Koo BK, et al. A novel noninvasive technology for treatment planning using virtual coronary stenting and computed tomography-derived computed fractional flow reserve. JACC Cardiovasc Interv. 2014;7:72–8.

    Article  PubMed  Google Scholar 

  70. FDA allows marketing of non-invasive device to help evaluate heart blood flow. 2014. Retrieved from http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm424945.htm. Accessed 12 June 2015.

  71. Wong DT, Ko BS, Cameron JD, et al. Transluminal attenuation gradient in coronary computed tomography angiography is a novel noninvasive approach to the identification of functionally significant coronary artery stenosis: a comparison with fractional flow reserve. J Am Coll Cardiol. 2013;61:1271–9.

    Article  PubMed  Google Scholar 

  72. Choi JH, Min JK, Labounty TM, et al. Intracoronary transluminal attenuation gradient in coronary CT angiography for determining coronary artery stenosis. JACC Cardiovasc Imaging. 2011;4:1149–57.

    Article  PubMed  Google Scholar 

  73. Yoon YE, Choi JH, Kim JH, et al. Noninvasive diagnosis of ischemia-causing coronary stenosis using CT angiography: diagnostic value of transluminal attenuation gradient and fractional flow reserve computed from coronary CT angiography compared to invasively measured fractional flow reserve. JACC Cardiovasc Imaging. 2012;5:1088–96. Demonstrated the diagnostic accuracy of transluminal attenuation gradient (TAG) compared to CT-perfusion against the gold standard of invasive FFR.

    Article  PubMed  Google Scholar 

  74. Einstein AJ. TAG-is it it?: improving coronary computed tomography angiography with the isotemporal transluminal contrast attenuation gradient. J Am Coll Cardiol. 2013;61:1280–2.

    Article  PubMed  Google Scholar 

  75. Wong DT, Ko BS, Cameron JD, et al. Comparison of diagnostic accuracy of combined assessment using adenosine stress computed tomography perfusion + computed tomography angiography with transluminal attenuation gradient + computed tomography angiography against invasive fractional flow reserve. J Am Coll Cardiol. 2014;63:1904–12.

    Article  PubMed  Google Scholar 

  76. Cury RC, Magalhaes TA, Borges AC, et al. Dipyridamole stress and rest myocardial perfusion by 64-detector row computed tomography in patients with suspected coronary artery disease. Am J Cardiol. 2010;106:310–5.

    Article  PubMed  Google Scholar 

  77. George RT, Arbab-Zadeh A, Miller JM, et al. Computed tomography myocardial perfusion imaging with 320-row detector computed tomography accurately detects myocardial ischemia in patients with obstructive coronary artery disease. Circ Cardiovasc Imaging. 2012;5:333–40.

    Article  PubMed  Google Scholar 

  78. Feuchtner G, Goetti R, Plass A, et al. Adenosine stress high-pitch 128-slice dual-source myocardial computed tomography perfusion for imaging of reversible myocardial ischemia: comparison with magnetic resonance imaging. Circ Cardiovasc Imaging. 2011;4:540–9. Demonstrated the diagnostic accuracy of CT-perfusion compared to invasive angiography and SPECT.

    Article  PubMed  Google Scholar 

  79. Bettencourt N, Chiribiri A, Schuster A, et al. Direct comparison of cardiac magnetic resonance and multidetector computed tomography stress-rest perfusion imaging for detection of coronary artery disease. J Am Coll Cardiol. 2013;61:1099–107.

    Article  PubMed  Google Scholar 

  80. Rochitte CE, George RT, Chen MY, et al. Computed tomography angiography and perfusion to assess coronary artery stenosis causing perfusion defects by single photon emission computed tomography: the CORE320 study. Eur Heart J. 2014;35:1120–30.

    Article  PubMed  Google Scholar 

  81. Ko BS, Cameron JD, Meredith IT, et al. Computed tomography stress myocardial perfusion imaging in patients considered for revascularization: a comparison with fractional flow reserve. Eur Heart J. 2012;33:67–77.

    Article  PubMed  Google Scholar 

  82. Berman DS, Stoebner RA, Dey D. Combined anatomy and physiology on coronary computed tomography angiography: a step or two in the right direction. J Am Coll Cardiol. 2014;63:1913–5.

    Article  PubMed  Google Scholar 

  83. George RT, Arbab-Zadeh A, Cerci RJ, et al. Diagnostic performance of combined noninvasive coronary angiography and myocardial perfusion imaging using 320-MDCT: the CT angiography and perfusion methods of the CORE320 multicenter multinational diagnostic study. AJR Am J Roentgenol. 2011;197:829–37.

    Article  PubMed Central  PubMed  Google Scholar 

  84. Bamberg F, Klotz E, Flohr T, et al. Dynamic myocardial stress perfusion imaging using fast dual-source CT with alternating table positions: initial experience. Eur Radiol. 2010;20:1168–73.

    Article  PubMed  Google Scholar 

  85. Bamberg F, Marcus RP, Becker A, et al. Dynamic myocardial CT perfusion imaging for evaluation of myocardial ischemia as determined by MR imaging. JACC Cardiovasc Imaging. 2014;7:267–77.

    Article  PubMed  Google Scholar 

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  1. Division of Cardiology, Department of Medicine, New York Presbyterian Hospital and Weill Cornell Medical College, New York, NY, USA

    Joshua Schulman-Marcus MD & Quynh A. Truong MD MPH

  2. Dalio Institute of Cardiovascular Imaging, Department of Radiology, New York Presbyterian Hospital and Weill Cornell Medical College, 413 East 69th Street, Suite 108, New York, NY, 10021, USA

    Joshua Schulman-Marcus MD, Ibrahim Danad MD & Quynh A. Truong MD MPH

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  1. Joshua Schulman-Marcus MD
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  3. Quynh A. Truong MD MPH
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Schulman-Marcus, J., Danad, I. & Truong, Q.A. State-of-the-Art Updates on Cardiac Computed Tomographic Angiography for Assessing Coronary Artery Disease. Curr Treat Options Cardio Med 17, 34 (2015). https://doi.org/10.1007/s11936-015-0398-6

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