title: Qualitative and quantitative assessment of adenosine triphosphate stress whole-heart dynamic myocardial perfusion imaging using 256-slice computed tomography.
abstract: BACKGROUND
  The aim of this study was to investigate the correlation of the qualitative transmural extent of hypoperfusion areas (HPA) using stress dynamic whole-heart computed tomography perfusion (CTP) imaging by 256-slice CT with CTP-derived myocardial blood flow (MBF) for the estimation of the severity of coronary artery stenosis.
  
  
  RESULTS
  Eleven patients underwent adenosine triphosphate (0.16 mg/kg/min, 5 min) stress dynamic CTP by 256-slice CT (coverage: 8 cm, 0.27 s/rotation), and 9 of the 11 patients underwent coronary angiography (CAG). Stress dynamic CTP (whole-heart datasets over 30 consecutive heart beats in systole without spatial and temporal gaps) was acquired with prospective ECG gating (effective radiation dose: 10.4 mSv). The extent of HPAs was visually graded using a 3-point score (normal, subendocardial, transmural). MBF (ml/100g/min) was measured by deconvolution. Differences in MBF (mean ± standard error) according to HPA and CAG results were evaluated. In 27 regions (3 major coronary territories in 9 patients), 11 coronary stenoses (> 50% reduction in diameter) were observed. In 353 myocardial segments, HPA was significantly related to MBF (P < 0.05; normal 295 ± 94; subendocardial 186 ± 67; and transmural 80 ± 53). Coronary territory analysis revealed a significant relationship between coronary stenosis severity and MBF (P < 0.05; non-significant stenosis [< 50%], 284 ± 97; moderate stenosis [50-70%], 184 ± 74; and severe stenosis [> 70%], 119 ± 69).
  
  
  CONCLUSIONS
  The qualitative transmural extent of HPA using stress whole-heart dynamic CTP imaging by 256-slice CT exhibits a good correlation with quantitative CTP-derived MBF and may aid in assessing the hemodynamic significance of coronary artery disease.
authors.affiliation: Department of Diagnostic and Therapeutic Radiology, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Kurata
authors.affiliation: Department of Diagnostic and Therapeutic Radiology, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Kawaguchi
authors.affiliation: Department of Diagnostic and Therapeutic Radiology, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Teruhito
authors.initials: T
authors.lastname: Kido
authors.affiliation: Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Katsuji
authors.initials: K
authors.lastname: Inoue
authors.affiliation: Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Suzuki
authors.affiliation: Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Ogimoto
authors.affiliation: Department of Cardiology, National Hospital Organization, Ehime National Hospital, Ehime, Japan.
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Funada
authors.affiliation: Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Jitsuo
authors.initials: J
authors.lastname: Higaki
authors.affiliation: Department of Diagnostic and Therapeutic Radiology, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Miyagawa
authors.affiliation: CT Clinical Science, Philips Healthcare, Cleveland, Ohio, United States of America.
authors.forename: Mani
authors.initials: M
authors.lastname: Vembar
authors.affiliation: Department of Diagnostic and Therapeutic Radiology, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Teruhito
authors.initials: T
authors.lastname: Mochizuki
mesh_terms: D000255:Adenosine Triphosphate / Q000494:pharmacology*; D003326:Coronary Circulation / Q000187:drug effects; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013312:Stress, Physiological / Q000187:drug effects*; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D000255:Adenosine Triphosphate