title: Rationale and design of the dual-energy computed tomography for ischemia determination compared to "gold standard" non-invasive and invasive techniques (DECIDE-Gold): A multicenter international efficacy diagnostic study of rest-stress dual-energy computed tomography angiography with perfusion.
abstract: BACKGROUND
  Dual-energy CT (DECT) has potential to improve myocardial perfusion for physiologic assessment of coronary artery disease (CAD). Diagnostic performance of rest-stress DECT perfusion (DECTP) is unknown.
  
  
  OBJECTIVE
  DECIDE-Gold is a prospective multicenter study to evaluate the accuracy of DECT to detect hemodynamic (HD) significant CAD, as compared to fractional flow reserve (FFR) as a reference standard.
  
  
  METHODS
  Eligible participants are subjects with symptoms of CAD referred for invasive coronary angiography (ICA). Participants will undergo DECTP, which will be performed by pharmacological stress, and participants will subsequently proceed to ICA and FFR. HD-significant CAD will be defined as FFR ≤ 0.80. In those undergoing myocardial stress imaging (MPI) by positron emission tomography (PET), single photon emission computed tomography (SPECT) or cardiac magnetic resonance (CMR) imaging, ischemia will be graded by % ischemic myocardium. Blinded core laboratory interpretation will be performed for CCTA, DECTP, MPI, ICA, and FFR.
  
  
  RESULTS
  Primary endpoint is accuracy of DECTP to detect ≥1 HD-significant stenosis at the subject level when compared to FFR. Secondary and tertiary endpoints are accuracies of combinations of DECTP at the subject and vessel levels compared to FFR and MPI.
  
  
  CONCLUSIONS
  DECIDE-Gold will determine the performance of DECTP for diagnosing ischemia.
authors.affiliation: Departments of Radiology, Weill Cornell Medical College, 413 E. 69th Street, Suite 108, New York, NY, 10021, USA.|Dalio Institute of Cardiovascular Imaging, New York Presbyterian Hospital, New York, NY, USA.
authors.forename: Quynh A
authors.initials: QA
authors.lastname: Truong
authors.affiliation: Department of Cardiology, VU Medical Center, Amsterdam, The Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Knaapen
authors.affiliation: Centro Cardiologico Monzino, Milan, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Pontone
authors.affiliation: Centro Cardiologico Monzino, Milan, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Andreini
authors.affiliation: Providence Health Care-St. Paul's Hospital, University of British Columbia, Vancouver, Canada.
authors.forename: Jonathon
authors.initials: J
authors.lastname: Leipsic
authors.affiliation: Diagnóstico Maipú, Buenos Aires, Argentina.
authors.forename: Patricia
authors.initials: P
authors.lastname: Carrascosa
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Lu
authors.affiliation: Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Kelley
authors.initials: K
authors.lastname: Branch
authors.affiliation: Division of Cardiology, Department of Medicine, Wexner Heart and Vascular Institute, The Ohio State University, Columbus, OH, USA.
authors.forename: Subha
authors.initials: S
authors.lastname: Raman
authors.affiliation: Midwest Heart & Vascular Associates, Kansas City, MO, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Bloom
authors.affiliation: Departments of Radiology, Weill Cornell Medical College, 413 E. 69th Street, Suite 108, New York, NY, 10021, USA. runone123@gmail.com.|Dalio Institute of Cardiovascular Imaging, New York Presbyterian Hospital, New York, NY, USA. runone123@gmail.com.
authors.forename: James K
authors.initials: JK
authors.lastname: Min
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology*; D005080:Exercise Test; D005500:Follow-Up Studies; D006801:Humans; D007391:International Cooperation; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000473:pathology*; D055414:Myocardial Perfusion Imaging; D010477:Perfusion; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012015:Reference Standards; D012107:Research Design; D018401:Sample Size; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Computed tomography; coronary artery disease; myocardial perfusion