Table 3. Most relevant studies of static single- and dual-energy CCTP imaging.
| Author [year] | Patients No. | CT Technology | CCTP protocol | Stressor (dose) | Obstructive CAD prevalence, per patient (%) | Monovessel/multivessel CAD (No.) | Average radiation dose (mSv) | Analysis basis | Reference standard | SE (%) | SP (%) | PPV (%) | NPV (%) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Single-energy CCTP studies | |||||||||||||
| Feuchtner et al. (29) [2011] | 30 | DS (2nd) | Stress/rest | Adenosine (0.14 mg/kg/min) | 96a | NA | 0.93 | Visual | MRI 1.5 T (for vessel) | 96 | 88 | 93 | 94 |
| Ko et al. (75) [2012] | 40 | 320-slice | Rest/stress | Adenosine (0.14 mg/kg/min) | 52.5b | 9/12 | 4.5 | TPR | FFR (for vessel) | 74 | 66 | 56 | 81 |
| Visual§ | FFR (for vessel) | 87 | 95 | 89 | 94 | ||||||||
| George et al. (76) [2012] | 50 | 320-slice | Rest/stress/LE | Adenosine (0.14 mg/kg/min) | 36c | 12/6 | 7.0 | TPR | SPECT (for patient) | 72 | 91 | 81 | 85 |
| Bettencourt et al. (77) [2013] | 101 | 64-slice | Stress/rest | Adenosine (0.14 mg/kg/min) | 47.5b | 24/24 | 5.0* | Visual§ | FFR (for patient) | 89 | 83 | 80 | 90 |
| MRI 1.5 T (for patient) | 67 | 95 | 91 | 78 | |||||||||
| Wong et al. (78) [2014] | 75 | 320-slice | Rest/stress | Adenosine (0.14 mg/kg/min) | NA | NA | 4.8 | Visual + TAG§ | FFR (for vessel) | 97 | 84 | 76 | 98 |
| Rochitte et al. [CORE320 study] (37) [2014] | 381 | 320-slice | Rest/stress | Adenosine (0.14 mg/kg/min) | 59d | NA | 5.31 | Semiq | QCA + SPECT (for patient) | 80 | 74 | 65 | 86 |
| George et al. [CORE320 study] (38) [2014] | 381 | 320-slice | Rest/stress | Adenosine (0.14 mg/kg/min) | 60d | 76/153 | NA | Semiq | QCA (for patient) | 88 | 55 | 75 | 75 |
| Yang et al. (79) [2015] | 75 | DS (2nd) | Stress/rest | Adenosine (0.14 mg/kg/min) | 81b | 41/20 | 6.5 | Visual | FFR (for patient) | 89 | 86 | 96 | 63 |
| FFR (for vessel) | 80 | 95 | 92 | 87 | |||||||||
| Magalhães et al. [CORE320 study] (39) [2015] | 381 | 320-slice | Rest/stress | Adenosine (0.14 mg/kg/min) | 59d | NA | NA | Visual§ | QCA + SPECT (for patient) | 78 | 73 | 64 | 85 |
| Cury et al. [Regadenoson crossover study] (40) [2015] | 110 | Multivendor | Stress/rest | Regadenoson (0.4 mg) | NA | NA | 17.7* | Semiq | SPECT | 90 | 82 | 53 | 97 |
| Dual-energy CCTP studies | |||||||||||||
| Ko et al. (31) [2012] | 45 | DS (1st) | Rest/stress | Adenosine (0.14 mg/kg/min) | 93d | 20/22 | 5.7 | Iodine map (for vessel) | QCA | 89 | 74 | 80 | 85 |
| Meinel et al. (80) [2014] | 55 | DS (2nd) | Stress/rest/LE | Adenosine (0.14 mg/kg/min); regadenoson (0.4 mg) | NA | NA | 7.1 | Iodine map (for segment) | SPECT | 99 | 97 | 92 | 100 |
| Delgado et al. (81) [2013] | 56 | DS (2nd) | Stress/rest/LE | Adenosine (0.14 mg/kg/min) | 27e | 11/4 | 5.2 | Iodine map (for segment) | MRI 1.5T | 76 | 99 | 89 | 98 |
| Kim et al. (82) [2014] | 50 | DS (2nd) | Stress/rest° | Adenosine (0.14 mg/kg/min) | 50e | NA | 6.5 | Iodine map (for segment) | MRI 1.5T | 77 | 94 | 53 | 98 |
| Ko et al. (83) [2014] | 40 | DS (1st) | CTCA/stress/rest | Adenosine (0.14 mg/kg/min) | NA | NA | 4.6 | Iodine map (for vessel)§ | QCA + MRI 3T | 87 | 79 | 71 | 91 |
| Ko et al. (84) [2014] | 100 | DS (1st) | Rest/stress | Adenosine (0.14 mg/kg/min) | 82d | 36/46 | 4.2 | Iodine map (for vessel)§ | QCA + MRI 1.5T and 3T | 88 | 79 | 73 | 91 |
°, the rest phase was acquired in the single-energy mode; *, global radiation dose of the stress-rest protocol; §, accuracy of CT perfusion integrated with the coronary anatomic data; a, data regarding coronary stenosis >70% by QCA performed in 25 out of 30 patients; b, data regarding FFR-hemodynamically significant stenosis; c, data regarding coronary stenosis ≥50% by CTCA; d, data regarding coronary stenosis ≥50% by QCA; e, data regarding coronary stenosis >50% by CTCA. CCTP, cardiac computed tomography perfusion; 1st and 2nd, first and second generation; CAD, coronary artery disease; CTCA, computed tomography coronary angiography acquired in the single-energy mode; DS, Dual-Source scanner; FFR, fractional flow reserve; LE, late-enhancement; MRI, magnetic resonance imaging; NA, non-assessable; No, patients’ number; NPV, negative predictive value; PPV, positive predictive value; QCA, quantitative coronary angiography; SE, sensitivity; SP, specificity; Semiq, semiquantitative analysis using a stress score; SPECT, myocardial perfusion scan; TPR, Transmural perfusion ratio; TAG, transluminal attenuation gradient.