title: Adenosine triphosphate stress dual-source computed tomography to identify myocardial ischemia: comparison with invasive coronary angiography.
abstract: OBJECTIVE
  The purpose of this study was to investigate the utility incremental diagnostic value of combined assessment with coronary CT angiography (CCTA) and myocardial CT perfusion imaging (CTP) using dual-energy technology with an Adenosine Triphosphate (ATP) load technique.
  
  
  METHODS
  Twenty-one patients underwent ATP-provocation dual-energy CT and CAG. We compared the diagnostic accuracy with CAG, for ischemic region due coronary stenosis by CCTA alone and CCTA combined with CTP (Combined CCTA/CTP).
  
  
  RESULTS
  All of 21 patients CTP images could be evaluated, however 8 CCTA images could not be evaluated by calcification and motion artifact, so assessability was 61.9% (13/21) for CCTA alone, and 100% for Combined CCTA/CTP. With CAG results as a comparison, the sensitivity, specificity, positive predictive value, and negative predictive value were, respectively, 83.3% (20/24), 74.4% (29/39), 66.7% (20/30), and 87.8% (29/33) for CCTA alone, and 66.7% (16/24), 92.3% (36/39), 84.2% (16/19), and 81.8% (36/44) for combined CCTA/CTP. The diagnostic accuracy of the two methods were 77.8% (49/63) and 82.5% (52/63).
  
  
  CONCLUSIONS
  Dual-energy CT may be a useful modality for perfusion assessment and correlated well with the severity of stenosis on CAG. This technique may even be of use in cases of severe calcification in the coronary artery wall.
authors.affiliation: Department of Radiology, Ehime University, Toon, Japan.
authors.forename: Teruhito
authors.initials: T
authors.lastname: Kido
authors.affiliation: Department of Cardiology, Saiseikai Matsuyama Hospital, Matsuyama, Japan.
authors.forename: Kouki
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Department of Cardiology, Saiseikai Matsuyama Hospital, Matsuyama, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Saeki
authors.affiliation: Department of Cardiology, Saiseikai Matsuyama Hospital, Matsuyama, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Shigemi
authors.affiliation: Department of Radiology, Saiseikai Matsuyama Hospital, Matsuyama, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsuda
authors.affiliation: Department of Radiology, Saiseikai Matsuyama Hospital, Matsuyama, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Radiology, Ehime University, Toon, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Kurata
authors.affiliation: Department of Radiology, Sherbrooke University, Quebec, Canada.
authors.forename: Rene Epunza
authors.initials: RE
authors.lastname: Kanza
authors.affiliation: Research and Collaboration, Siemens Japan, Tokyo, Japan.
authors.forename: Toshihide
authors.initials: T
authors.lastname: Itoh
authors.affiliation: Department of Radiology, Ehime University, Toon, Japan.
authors.forename: Teruhito
authors.initials: T
authors.lastname: Mochizuki
keywords: Dual Energy CT; Ischemia; Myocardium; Perfusion CT