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Rizvi, Asim,Han, Donghee,Danad, Ibrahim,Ó,Hartaigh, Brí,ain,Lee, Ji Hyun,Gransar, Heidi,Stuijfzand, Wijnand J.,Roudsari, Hadi Mirhedayati,Park, Mahn Won,Szymonifka, Jackie,Chang, Hyuk-Jae Elsevier 2018 JACC CARDIOVASCULAR IMAGING Vol.11 No.4
<P><B>Abstract</B></P> <P><B>Objectives</B></P> <P>The current meta-analysis aimed to evaluate the diagnostic performance of hybrid cardiac imaging techniques compared with stand-alone coronary computed tomography angiography (CTA) for assessment of obstructive coronary artery disease (CAD).</P> <P><B>Background</B></P> <P>The usefulness of coronary CTA for detecting obstructive CAD remains suboptimal at present. Myocardial perfusion imaging encompasses positron emission tomography, single-photon emission computed tomography, and cardiac magnetic resonance, which permit the identification of myocardial perfusion defects to detect significant CAD. A hybrid approach comprising myocardial perfusion imaging and coronary CTA may improve diagnostic performance for detecting obstructive CAD.</P> <P><B>Methods</B></P> <P>PubMed and Web of Knowledge were searched for relevant publications between January 1, 2000 and December 31, 2015. Studies using coronary CTA and hybrid imaging for diagnosis of obstructive CAD (a luminal diameter reduction of >50% or >70% by invasive coronary angiography) were included. In total, 12 articles comprising 951 patients and 1,973 vessels were identified, and a meta-analysis was performed to determine pooled sensitivity, specificity, and summary receiver-operating characteristic curves.</P> <P><B>Results</B></P> <P>On a per-patient basis, the pooled sensitivity of hybrid imaging was comparable to that of coronary CTA (91% vs. 90%; p = 0.28). However, specificity was higher for hybrid imaging versus coronary CTA (93% vs. 66%; p < 0.001). On a per-vessel basis, sensitivity for hybrid imaging against coronary CTA was comparable (84% vs. 89%; p = 0.29). Notably, hybrid imaging yielded a specificity of 95% versus 83% for coronary CTA (p < 0.001). Summary receiver-operating characteristic curves displayed improved discrimination for hybrid imaging beyond coronary CTA alone, on a per-vessel basis (area under the curve: 0.97 vs. 0.93; p = 0.047), although not on a per-patient level (area under the curve: 0.97 vs. 0.93; p = 0.132).</P> <P><B>Conclusions</B></P> <P>Hybrid cardiac imaging demonstrated improved diagnostic specificity for detection of obstructive CAD compared with stand-alone coronary CTA, yet improvement in overall diagnostic performance was relatively limited.</P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>
Multimodality Imaging in Coronary Artery Disease: Focus on Computed Tomography
이지현,한동희,Ibrahim Danad,Bríain ó Hartaigh,Fay Y. Lin,James K. Min 한국심초음파학회 2016 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.24 No.1
Coronary artery disease (CAD) is the leading cause of mortality worldwide, and various cardiovascular imaging modalities havebeen introduced for the purpose of diagnosing and determining the severity of CAD. More recently, advances in computed tomography(CT) technology have contributed to the widespread clinical application of cardiac CT for accurate and noninvasive evaluationof CAD. In this review, we focus on imaging assessment of CAD based upon CT, which includes coronary artery calciumscreening, coronary CT angiography, myocardial CT perfusion, and fractional flow reserve CT. Further, we provide a discussion regardingthe potential implications, benefits and limitations, as well as the possible future directions according to each modality.
Computational Methods for Patient-Specific Perfusion Simulations of Coronary Arteries
Hyun Jin Kim(김현진),L. Papamanolis,C. Jaquet,M. Sinclair,M. Schaap,I. Danad,P. van Diemen,P. Knaapen,L. Najman,H. Talbot,C. A. Taylor,I. E. Vignon-Clementel 대한기계학회 2021 대한기계학회 춘추학술대회 Vol.2021 No.4
Patient-specific computational simulations of blood flow are utilized to diagnose and predict treatment outcomes of coronary artery disease. The computational simulations, however, are limited when estimating perfusion in the myocardium as multiscale vessels from arteries to capillaries need to be developed. We propose a multiscale patient-specific computational model framework to simulate blood flow from large coronary arteries to myocardial tissues. Patient vasculatures were segmented from coronary computed tomography angiography data and then extended from the image-based model down to the arteriole level using a space-filling synthetic forest of arterial trees. Blood flow is modelled by coupling a 1-D model of the coronary arteries to a single-compartment Darcy myocardium model. Simulated results for 5 patients with non-obstructive coronary artery disease are compared to [<sup>15</sup>O]H<sub>2</sub>O PET exam data for both resting and hyperemic conditions. Results on a patient with a severe disease demonstrate coronary artery disease can predict myocardial regions with perfusion deficit. This multiscale computational model of simulating blood flow from the epicardial coronary arteries to the left ventricle myocardium will be further validated and applied to human data.