CT myocardial perfusion: state of the science

Non-invasive cardiac imaging has rapidly evolved during the last decade due to advancements in CT technologies. Coronary CT angiography (CCTA) has been shown to reliably assess the coronary anatomy and has established itself as the non-invasive imaging technique with the highest sensitivity and specificity in the evaluation of patients with suspected coronary artery disease (CAD). However, this technique has previously been limited to a pure anatomical assessment. CT myocardial perfusion imaging (CT-MPI) is an increasingly rediscovered CT technique able to provide functional assessment of the myocardium and, when combined with CTA, allows for a comprehensive assessment of the coronary arteries, all done within a single modality. This review will describe the current knowledge in CT-MPI, including the varying techniques as well as a summary of the current literature.