‘One stop’ CT perfusion requires less contrast, radiation dose than CCTA

A new myocardial computed tomography perfusion (CTP) imaging protocol offers more diagnostic information with fewer potential drawbacks compared to conventional coronary CT angiography (CCTA), according to a new study.

The new “one-stop” approach combines CTP and CCTA, and acquires a variety of important cardiac measurements all at the same time. China-based researchers shared their method Dec. 17 in Academic Radiology, noting it may alter the landscape for patients with damage in the heart’s major blood vessels.

Compared to a conventional CCTA protocol, an advanced ‘one-stop’ CTP protocol can provide information on coronary anatomy, myocardial perfusion, and left ventricular cardiac function with reduced radiation and contrast medium volume,” Keling Liu, with Sichuan University’s West China Hospital, and colleagues wrote. “Its integration into the imaging examinations would potentially help with clinical decision and care for patients with suspected coronary artery disease."

Over the past 10 years, CCTA has been “excellent” for noninvasively imaging suspected CAD, the authors wrote. The technique, however, can’t measure important changes in cardiac function, and typically requires downstream exams such as MRI or echocardiography to finish the job. These additions tack on extra costs, inconvenience and in some cases, radiation exposure.

To determine the feasibility of one-stop imaging, Liu and colleagues randomly divided 442 patients with suspected CAD into two groups: One that underwent one-stop CTP and another that received CCTA. The first cohort was also broken into four subgroups dependent on their severity of coronary artery blockage.

Overall, all-in-one CTP offered more comprehensive information with no loss of image quality compared to CCTA. Patients who received CTP experienced an 11.7% reduction in radiation dosage, but did face scan times that were 73.1 seconds longer than those in the CCTA group.

""

Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.

Around the web

Positron, a New York-based nuclear imaging company, will now provide Upbeat Cardiology Solutions with advanced PET/CT systems and services. 

The nuclear imaging isotope shortage of molybdenum-99 may be over now that the sidelined reactor is restarting. ASNC's president says PET and new SPECT technologies helped cardiac imaging labs better weather the storm.

CMS has more than doubled the CCTA payment rate from $175 to $357.13. The move, expected to have a significant impact on the utilization of cardiac CT, received immediate praise from imaging specialists.