Abstract Multi-detector computed tomography (MDCT) assessment of myocardial perfusion is based on visualization of 2D slices. To overcome the subjective nature of this analysis, we developed a new technique for quantification of myocardial perfusion from MDCT 3D datasets and tested it against nuclear myocardial perfusion imaging (MPI Introduction While MDCT is increasingly used as an alternative to invasive coronary angiography, recent studies have demonstrated its potential to provide perfusion information, which could be a valuable addition in the diagnosis of coronary artery disease (CAD). These studies reported hypoenhanced areas corresponding to scar visualized in patients post myocardial infarction (MI), and in animals with acute MI We recently developed a new quantitative index of perfusion that was designed to take into account these differences, and tested it on 2D slices. The addition of this analysis improved the diagnostic accuracy of MDCT evaluation of CAD, especially in patients with high calcium scores and stents Methods We studied 44 patients who underwent CT coronary angiography (CTCA) for the evaluation of CAD. These patients were divided into a study group of 29 patients (age: 62±10, 23 males) who also had MPI within 57±72 days (14 patient with normal MPI both at rest and stress and 15 patients with perfusion defects on MPI), and a control group of 15 patients (age: 58±16, 8 males) who had normal MPI both at rest and stress and no significant stenosis on CTCA. Patients who underwent coronary interventions between MPI and CTCA were excluded. MDCT imaging All CTCA studies were clinically indicated and performed according to a standard protocol. Images were obtained using an MDCT scanner (64-channels, Philips) with retrospective ECG-gating. A nonionic iodinated contrast agent was used (40-80 ml iv at 5-6 ml/sec)
