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Updated: Oct 5, 2025
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Myocardial CT perfusion imaging for the detection of obstructive coronary artery disease: multisegment reconstruction
Daniel Preuß1, Gonzalo Garcia1, Michael Laule2
1Department of Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany.
Insights
Multisegment reconstruction (MSR) for myocardial CT perfusion did not improve diagnostic performance for detecting coronary artery disease (CAD) compared to half-scan reconstruction (HSR). MSR also increased radiation dose, making HSR a preferable method for CTP imaging.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Computed tomography (CT) utilizes multisegment reconstruction (MSR) to shorten temporal windows and reduce motion artifacts.
- Myocardial CT perfusion (CTP) imaging is crucial for diagnosing coronary artery disease (CAD).
Purpose of the Study:
- To evaluate if MSR of CTP enhances diagnostic performance in detecting obstructive CAD compared to half-scan reconstruction (HSR).
Main Methods:
- A prospective study included 134 patients undergoing invasive coronary angiography.
- Retrospective analysis of CTP data from 93 patients compared MSR and HSR for detecting perfusion defects.
- Diagnostic performance was assessed using the area under the curve (AUC) with ≥50% stenosis as the reference standard.
Main Results:
- Overall AUC for MSR (0.65) was inferior to HSR (0.79) (p=0.011).
- AUCs were similar across subgroups, including known CAD, suspected CAD, and high heart rate.
- Median radiation dose was significantly higher for MSR (6.67 mSv) than HSR (3.64 mSv) (p<0.001).
Conclusions:
- MSR does not improve diagnostic performance for myocardial CTP in detecting obstructive CAD.
- MSR leads to a higher radiation dose compared to HSR.
- HSR remains a more effective reconstruction method for CTP analysis.
Background:
Multisegment reconstruction (MSR) was introduced to shorten the temporal reconstruction window of computed tomography (CT) and thereby reduce motion artefacts. We investigated whether MSR of myocardial CT perfusion (CTP) can improve diagnostic performance in detecting obstructive coronary artery disease (CAD) compared with halfscan reconstruction (HSR).
Methods:
A total of 134 patients (median age 65.7 years) with clinical indication for invasive coronary angiography and without cardiac surgery prospectively underwent static CTP. In 93 patients with multisegment acquisition, we retrospectively performed both MSR and HSR and searched both reconstructions for perfusion defects. Subgroups with known (n = 68) or suspected CAD (n = 25) and high heart rate (n = 30) were analysed. The area under the curve (AUC) was compared applying DeLong approach using ≥ 50% stenosis on invasive coronary angiography as reference standard.
Results:
Per-patient analysis revealed the overall AUC of MSR (0.65 [95% confidence interval 0.53, 0.78]) to be inferior to that of HSR (0.79 [0.69, 0.88]; p = 0.011). AUCs of MSR and HSR were similar in all subgroups analysed (known CAD 0.62 [0.45, 0.79] versus 0.72 [0.57, 0.86]; p = 0.157; suspected CAD 0.80 [0.63, 0.97] versus 0.89 [0.77, 1.00]; p = 0.243; high heart rate 0.46 [0.19, 0.73] versus 0.55 [0.33, 0.77]; p = 0.389). Median stress radiation dose was higher for MSR than for HSR (6.67 mSv versus 3.64 mSv, p < 0.001).
Conclusions:
MSR did not improve diagnostic performance of myocardial CTP imaging while increasing radiation dose compared with HSR.
Trial Registration:
CORE320: clinicaltrials.gov NCT00934037, CARS-320: NCT00967876.
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