title: Semiautomated Global Quantification of Left Ventricular Myocardial Perfusion at Stress Dynamic CT:: Diagnostic Accuracy for Detection of Territorial Myocardial Perfusion Deficits Compared to Visual Assessment.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy of semiautomated global quantification of left ventricular myocardial perfusion derived from stress dynamic computed tomography myocardial perfusion imaging (CTMPI) for detection of territorial perfusion deficits (PD).
  
  
  METHODS
  Dynamic CTMPI datasets of 71 patients were analyzed using semiautomated volume-based software to calculate global myocardial blood flow (MBF), myocardial blood volume, and volume transfer constant. Optimal cutoff values to assess the diagnostic accuracy of these parameters for detection of one- to three-vessel territories with PD in comparison to visual analysis were calculated.
  
  
  RESULTS
  Nonsignificant differences (P = 0.694) were found for average global MBF in patients without PD and single-territorial PD. Significant differences were found for mean global MBF in patients with PD in two (P < 0.0058) and three territories (P < 0.0003). Calculated optimal thresholds for global MBF and myocardial blood volume resulted in a sensitivity, specificity, and negative predictive value of 100% for detection of three-vessel territory PD. For detection of ≥2 territories with PD, global MBF was superior to other parameters (sensitivity 81.3%, specificity 90.9%, and negative predictive value 94.3%).
  
  
  CONCLUSIONS
  Semiautomated global quantification of left ventricular MBF during stress dynamic CTMPI shows high diagnostic accuracy for detection of ≥2 vessel territories with PD, facilitating identification of patients with multi-territorial myocardial PD.
authors: Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC 29425; Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany.
authors: Julian L
authors: JL
authors: Wichmann
authors: Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC 29425; Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany.
authors: Felix G
authors: FG
authors: Meinel
authors: Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC 29425; Division of Cardiology, Department of Medicine, Medical University of South Carolina, Ashley River Tower, MSC 592, 25 Courtenay Drive, Charleston, SC 29425. Electronic address: schoepf@musc.edu.
authors: U Joseph
authors: UJ
authors: Schoepf
authors: Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC 29425.
authors: Akos
authors: A
authors: Varga-Szemes
authors: Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC 29425; Department of Radiological Sciences, Oncology and Pathology, University of Rome "Sapienza"-Polo Pontino, Latina, Italy.
authors: Giuseppe
authors: G
authors: Muscogiuri
authors: Department of Radiological Sciences, Oncology and Pathology, University of Rome "Sapienza"-Polo Pontino, Latina, Italy; Scuola di Specializzazione in Radiodiagnostica, University of Milan, Milano, Italy.
authors: Paola M
authors: PM
authors: Cannaò
authors: Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC 29425.
authors: Andrew D
authors: AD
authors: McQuiston
authors: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors: Yeon Hyeon
authors: YH
authors: Choe
authors: Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors: Yining
authors: Y
authors: Wang
authors: Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC 29425; Department of Radiological Sciences, Oncology and Pathology, University of Rome "Sapienza"-Polo Pontino, Latina, Italy.
authors: Carlo N
authors: CN
authors: De Cecco
mesh_terms: D000241:Adenosine / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods; D011856:Radiographic Image Enhancement; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D003287:Contrast Media; D014665:Vasodilator Agents; D000241:Adenosine
keywords: Myocardial perfusion imaging; coronary artery disease; multidetector computed tomography