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Updated: Feb 14, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Dynamic stress computed tomography myocardial perfusion for detecting myocardial ischemia: A systematic review and
Minjie Lu1, Shuli Wang2, Arlene Sirajuddin3
1Department of Magnetic Resonance Imaging, Cardiovascular Imaging and Intervention Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China; Department of Health and Human Services, National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health (NIH), Building 10, Room B1D416, MSC 1061, 10 Center Drive, Bethesda, MD, 20892-1061, USA.
Insights
Dynamic CT myocardial perfusion (DCTMP) shows high accuracy in diagnosing myocardial ischemia. This advanced imaging technique offers superior resolution and reduced radiation, making it a promising tool for cardiac assessment.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Diagnostic Accuracy Studies
Background:
- Myocardial computed tomography perfusion (DCTMP) is emerging as a valuable tool for assessing hemodynamic myocardial ischemia.
- DCTMP offers advantages over SPECT and MRI, including higher temporal and spatial resolution and reduced radiation dose.
- This meta-analysis evaluates the diagnostic performance of DCTMP for myocardial ischemia.
Purpose of the Study:
- To systematically analyze the diagnostic accuracy of dynamic CT myocardial perfusion (DCTMP) in detecting myocardial ischemia.
- To compare the performance of DCTMP against established reference standards such as MR/SPECT/PET perfusion and fractional flow reserve (FFR).
Main Methods:
- A systematic literature search was conducted across PubMed, Embase, and Web of Science databases.
- Eligible studies evaluating the accuracy of DCTMP for diagnosing myocardial ischemia were included.
- A bivariate mixed-effects regression model was employed to synthesize data from 13 studies involving 482 patients.
Main Results:
- Pooled sensitivity and specificity for myocardial blood flow (MBF) using DCTMP were high across segment, artery, and patient levels.
- At the segment level, sensitivity was 0.83 and specificity was 0.90.
- High areas under the summary receiver operating characteristic (sROC) curves (0.944-0.949) indicate excellent diagnostic performance.
Conclusions:
- Dynamic CT myocardial perfusion (DCTMP) demonstrates high diagnostic accuracy for detecting myocardial ischemia.
- The diagnostic performance of DCTMP may be further enhanced when used in conjunction with coronary CT angiography (CCTA) at the segment level.
Background:
Comparing to SPECT and MRI, with higher temporal and spatial resolution and development of radiation dose reduction, myocardial computed tomography perfusion has emerged as a potential method for evaluation of hemodynamic myocardial ischemia. This meta-analysis systematically analyzed the performance of dynamic CT myocardial perfusion (DCTMP) to diagnose myocardial ischemia (MI) with clinically established reference methods [MR/SPECT/PET perfusion and fractional flow reserve (FFR)] as the reference standard.
Methods:
We searched PubMed, Embase and web of science databases for all published studies that evaluated the accuracy of DCTMP to diagnose MI met our inclusion criteria. An exact binomial rendition of the bivariate mixed-effects regression model with test type as a random-effects covariate was performed to synthesize the available data.
Results:
The search revealed 13 eligible studies including 482 patients. The pooled sensitivity and specificity of myocardial blood flow (MBF) were 0.83 (95% CI: 0.80 to 0.86) and 0.90 (95% CI: 0.88 to 0.91) at the segment level, 0.85 (95% CI: 0.80 to 0.88) and 0.81 (95% CI: 0.78 to 0.84) at the artery level, and 0.93 (95% CI: 0.82 to 0.98) and 0.82 (95% CI: 0.70 to 0.91), at the patient level, respectively. The high area under the sROC curves of MBF were 0.944 at segment level, 0.911 at vessel level and 0.949 at patient level, respectively.
Conclusions:
DCTMP has a high diagnostic accuracy in detecting myocardial ischemia and it may increase significantly at segment level in combined use of coronary CTA.
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