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Updated: Jul 5, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
CT coronary angiography: quantitative assessment of myocardial perfusion using test bolus data-initial experience
Ashley M Groves1, Vicky Goh, Sabarinath Rajasekharan
1Institute of Nuclear Medicine, University College Hospital, UCLH NHS Foundation Trust, London, UK. drashleygroves@hotmail.com
Insights
Quantifying myocardial perfusion with coronary CT angiography is feasible using a modified test-bolus technique. This method provides CT-derived perfusion values consistent with established methods, aiding in diagnosing coronary artery disease.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Medical Physics
Background:
- Coronary CT angiography (CCTA) is a primary tool for diagnosing coronary artery disease.
- Accurate quantification of myocardial perfusion is crucial for assessing ischemic heart disease.
- Existing perfusion quantification methods often require separate imaging modalities.
Purpose of the Study:
- To evaluate the feasibility of quantifying myocardial perfusion using data acquired during a routine coronary CT angiography (CCTA) examination.
- To compare CT-derived myocardial perfusion values with those obtained from cardiac (82)Rubidium-PET perfusion imaging.
- To validate a modified timing test-bolus acquisition protocol for myocardial perfusion assessment.
Main Methods:
- Nineteen patients with suspected coronary artery disease underwent combined CCTA and cardiac (82)Rubidium-PET perfusion imaging.
- A retrospectively ECG-gated dynamic test bolus of IV contrast was acquired prior to CCTA.
- Myocardial perfusion was calculated using the maximum-slope and peak methods based on time density curves derived from CT data.
Main Results:
- CT-derived resting myocardial perfusion values were calculated using the maximum-slope method (0.89 mL/min/g end-systole, 0.93 mL/min/g end-diastole) and the peak method (0.69 mL/min/g end-systole, 0.79 mL/min/g end-diastole).
- These CT-derived values demonstrated consistency with published myocardial perfusion values obtained via other imaging techniques.
- The study confirmed that myocardial perfusion can be quantified from a standard CCTA test bolus acquisition.
Conclusions:
- Quantification of myocardial perfusion is achievable using data from a modified test-bolus acquisition during routine coronary CT angiography.
- CT-derived myocardial perfusion measurements are comparable to those obtained from established techniques like PET.
- This approach offers a potential method for integrated anatomical and functional assessment of coronary artery disease in a single CCTA examination.
Abstract:
The aim of this study is to quantify myocardial perfusion during coronary CT angiography using data from a modified timing test-bolus acquisition. Institutional review board approval and informed consent were obtained. Nineteen patients with suspected coronary artery disease underwent combined coronary CT angiography and cardiac (82)Rubidium-PET perfusion. Prior to the CT angiogram a retrospectively ECG-gated dynamic test bolus was obtained following 25 mls of IV contrast medium injected at 5 ml/s. Images were acquired every 1.5 s for 30 s using 4 x 1.25-mm slices at 120 kV, 35 mAs. Regions of interest were drawn to delineate the myocardium and aorta on the resulting transaxial images. Time density curves were created and perfusion calculated using two simple approaches: maximum-slope method and peak method. In patients with normal PET myocardial perfusion, the mean (SD) resting myocardial perfusion estimated by CT using the maximum-slope method was 0.89 (+/-0.27) ml/min/g and 0.93 (+/-0.21) ml/min/g at end-systole and end-diastole, respectively, and 0.69 (+/-0.11) ml/min/g and 0.79 (+/-0.19) at end-systole and end-diastole, respectively, for the peak method. Thus quantification of myocardial perfusion from a routine coronary CT angiography test bolus is possible. CT-derived myocardial perfusion values are consistent with published values derived from other techniques.
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