Beek, Aernout M

Brinckman, Stijn L

Groothuis, Jan GJ

Hofman, Mark BM

Meijerink, Martijn R

van den Oever, Mijntje LP

van Kuijk, Cornelis

van Rossum, Albert C

English

PubMed

van Kuijk Cornelis

Hofman Mark

van den Oever Mijntje

Meijerink Martijn R

Brinckman Stijn L

Beek Aernout M

Groothuis Jan GJ

van Rossum Albert C

Directory of Open Access Journals

Journal of Cardiovascular Magnetic Resonance

Combined anatomical and functional diagnostic work-up of patients with suspected coronary artery disease using cardiac computed tomography and magnetic resonance imaging

Jan GJ Groothuis

Aernout M Beek

Stijn L Brinckman

Martijn R Meijerink

Mijntje LP van den Oever

Mark BM Hofman

Cornelis van Kuijk

Albert C van Rossum

Crossref

Mijntje van den Oever

Mark Hofman

Springer - Publisher Connector

POSTER PRESENTATION Open Access
Combined anatomical and functional diagnostic
work-up of patients with suspected coronary
artery disease using cardiac computed
tomography and magnetic resonance imaging
Jan GJ Groothuis*, Aernout M Beek, Stijn L Brinckman, Martijn R Meijerink, Mijntje LP van den Oever,
Mark BM Hofman, Cornelis van Kuijk, Albert C van Rossum
From 2011 SCMR/Euro CMR Joint Scientific Sessions
Nice, France. 3-6 February 2011
Introduction
The combined use of cardiac computed tomography
coronary angiography (CTCA) and myocardial perfusion
imaging allows the non-invasive evaluation of coronary
morphology and function. Cardiovascular magnetic reso-
nance imaging (CMR) has several advantages: it can
simultaneous assess myocardial perfusion, ventricular
and valvular function, cardiomyopathy and aortic disease
and does not involve any ionizing radiation.
Purpose
To investigate the usefulness of a combined non-inva-
sive anatomical and functional work-up using cardiac
computed tomography (CT) and CMR for the diagnostic
evaluation of patients with suspected coronary artery
disease (CAD) in clinical practice.
Methods
Patients with low or intermediate pre-test probability of
CAD underwent CT (Siemens Sensation 64, coronary
calcium scoring and coronary angiography (CTCA)) and
CMR (Siemens Sonata/Avanto, assessment of ventricular
function, adenosine stress myocardial perfusion and late
gadolinium enhancement imaging). Patients were
referred for invasive coronary angiography (ICA) on the
basis of obstructive CAD on CTCA (at least 1 lesion
causing > 50% diameter stenosis), myocardial ischemia
on CMR or clinical assessment by their physician. Frac-
tional flow reserve measurements (FFR) were performed
in case of intermediate lesions on ICA. Patients with no
or non-obstructive CAD on CTCA and normal myocar-
dial perfusion on CMR who did not undergo ICA were
followed-up. The diagnostic performance for detection
of significant CAD was determined for CTCA, CMR
and the combination of CTCA and CMR. Significant
CAD was defined as a FFR of ≤ 0.75. When no FFR
measurements were available, a lesion was regarded as
significant when the diameter stenosis was > 50% in two
orthogonal directions using quantitative coronary analy-
sis. Additional cardiac and extra-cardiac findings by CT
and CMR were registered.
Results
A total of 192 patients were included, 88 (46%) of whom
underwent ICA. The combination of CTCA and CMR
resulted in a significant improvement of specificity and
overall accuracy for detection of significant CAD com-
pared to CTCA or CMR alone: 94% and 91% versus 39%
and 57%, p<0.0001 (CTCA) or 82% and 83%, p=0.016
(CMR), respectively. No events were recorded during fol-
low-up (538±169 days) in 104 patients who did not
undergo ICA. The combined strategy provided an
VU University Medical Center, Amsterdam, Netherlands
Full list of author information is available at the end of the article
Groothuis et al. Journal of Cardiovascular Magnetic Resonance 2011, 13(Suppl 1):P77
http://jcmr-online.com/content/13/S1/P77
© 2011 Groothuis et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.
alternative diagnosis in 18 patients (myocarditis, hyper-
trophic cardiomyopathy and dilated cardiomyopathy).
Conclusions
The combined use of CT and CMR significantly
improved the specificity and overall diagnostic accuracy
for detection of hemodynamically significant CAD, and
allowed the detection of alternative diagnoses.
Published: 2 February 2011
doi:10.1186/1532-429X-13-S1-P77
Cite this article as: Groothuis et al.: Combined anatomical and
functional diagnostic work-up of patients with suspected coronary
artery disease using cardiac computed tomography and magnetic
resonance imaging. Journal of Cardiovascular Magnetic Resonance 2011 13
(Suppl 1):P77.
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Groothuis et al. Journal of Cardiovascular Magnetic Resonance 2011, 13(Suppl 1):P77
http://jcmr-online.com/content/13/S1/P77
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Combined anatomical and functional diagnostic work-up of patients with suspected coronary artery disease using cardiac computed tomography and magnetic resonance imaging

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