Adenosine-Stress Dynamic Myocardial Volume Perfusion Imaging with Second Generation Dual-Source CT: Concepts and First Experiences

Objective:
Recent research suggests that multi detector-row CT may have potential as a standalone modality for integrative imaging of coronary heart disease, including the assessment of the myocardial perfusion. However, the technical prerequisites for volumetric, time-resolved imaging of the passage of a contrast medium bolus through the myocardium have only been met with latest generation wide-detector CT scanners.

Methods:
Second generation dual-source CT enables performing ECG-synchronized dynamic myocardial perfusion imaging by means of a dedicated “shuttle” mode. With this acquisition mode, image data can be acquired during contrast medium infusion at two alternating table positions with the table shuttling back and forth between the two positions covering a 73 mm anatomic volume. We applied this acquisition technique for detecting differences in perfusion patterns between healthy and diseased myocardium and for quantifying myocardial blood flow under adenosine stress in three patients with coronary heart disease.

Conclusion:
According to our initial experience, the addition of adenosine stress volumetric dynamic CT perfusion to a cardiac CT protocol comprising coronary artery calcium quantification, prospectively ECG-triggered coronary CT angiography, and delayed acquisition appears promising for the comprehensive assessment of coronary artery luminal integrity, cardiac function, perfusion, and viability with a single modality.

Full article: Journal of Cardiovascular Computed Tomography, Jan.2010

Authors:
Gorka Bastarrika1,2, MD, PhD; Luis Ramos-Duran1, MD; U. Joseph Schoepf1,3, MD; Michael A. Rosenblum3, MD; Joseph A. Abro1, MA; Robin L. Brothers, RT1;
José L. Zubieta2, MD, PhD; Salvatore A. Chiaramida3, MD; Doo Kyoung Kang1,4, MD