Dual Energy CT of the Heart: Perfusion and Beyond

Size: px
Start display at page:

Download "Dual Energy CT of the Heart: Perfusion and Beyond"

Transcription

1 Dual Energy CT of the Heart: Perfusion and Beyond U. Joseph Schoepf, MD, FAHA, FSCBT MR, FSCCT Professor of Radiology, Medicine, and Pediatrics Director of Cardiovascular Imaging

2 Disclosures Consultant for / research support from Bayer Bracco General Electric Medrad Siemens

3 Integrative CHD Imaging with CT Primary morphological vs. functional evaluation of CAD (i.e. SPECT vs. ICA, CTA)? Early attempts at CT imaging Limited by experimental nature Limited by dedicated acquisition protocols Hybrid Imaging (e.g. SPECT and CT) Dual energy CT for myocardial perfusion defects Delayed enhancement dual energy CT Adenosine stress dual energy CT Quantitative, time resolved perfusion assessment

4 EBCT: Porcine Model of Myocardial Perfusion Perfusion CT: Animal Models Mohlenkamp, S. et al. Circulation 2000

5 Infarct Detection with CT CT for Myocardial Signs of CHD Nikolaou K. et al., Eur Radiol 2005

6 140kV 80 / 100kV Integrative Imaging: DECT

7 DECT for Myocardial Ischemia 74 yo woman with chest pain and abnormal SPECT 2x64x0.6mm, 80kV/140kV 0.33 s rotation time

8 Morphology and Function: DECT 74 yo woman with chest pain and abnormal SPECT Tight proximal stenosis D1 B. Ruzsics et al., Circulation 2008

9 Morphology and Function: DECT 74 yo woman with chest pain and abnormal SPECT B. Ruzsics et al., Circulation 2008

10 DECT Postprocessing F. Schwarz et al., Eur J Radiol 2008

11 DECT Radiation Dose 16 Slice CT DSCT DECT 12 ± 3.59 msv 9.8 ± 4.77 msv 4.54 ± 1.87 msv JM Kerl et al., Eur Radiol 2010

12

13 61 yo man, atypical chest pain Reversible Ischemia at Rest DECT

14 Vliegenthart et al., AJR in press DECT Can Detect Subtle Pathology

15 Ruszsics et al., RSNA 2009 Delayed Enhancement DECT

16 1 month 0 1 week Abnormal SPECT rest and/or stress Rest DECT Adenosine DECT Rest cemri (perfusion) Adenosine cemri (perfusion) Adenosine protocol: 140 µg/min/kg Delayed DECT (sequential) Delayed Enhancement (viability) B. Ruzsics et al., AHA 2008 Adenosine Stress DECT

17 Adenosine Stress DECT LM LAD D1 Reversible Ischemia

18 Adenosine Stress cmri Reversible Ischemia

19 Rest Stress Delayed Reversible Ischemia

20 Larger scan field of view (SFOV) for Dual Energy modes SFOV A/B detector: 50/33 cm 33 cm Next Generation DECT

21 Dual Energy with Selective Photon Shield Up to 80% improved separation of low and high energies Minimized spectral overlap Noise reduction Greater dose reserve Complete radiation dose neutrality compared with single energy CT number of quanta S 1 : 80 kv x S 2 : 140 kv + SPS 80 kv 140 kv 140 kv + SPS 0.4 mm Sn photon energy (kev) Next Generation DECT

22 75 msec Temporal Resolution in Dual Energy Mode 165 msec 75 msec DECT Temporal Resolution

23 Next Generation DECT

24 Quantitative DECT Perfusion Rest Stress

25 ECG triggered sequential shuttle mode, coverage 8 cm 4 cm 4 cm Dynamic Time Resolved Perfusion

26 Untitled-2 Stress Dynamic CT Perfusion Protocol G. Bastarrika et al., Invest Radiol 2010

27 140 µg/min/kg Adenosine Stress Dynamic Time Resolved Perfusion G. Bastarrika et al., J Cardiovasc Comput Tomography 2010

28 Absolute MBF Quantification MBF: 124ml/100 ml/min MBF: 60ml/100 ml/min

29 ccta Perfusion Viability Dynamic Time Resolved Perfusion G. Bastarrika et al., Invest Radiol 2010

30 50yo man w/ chest pain

31 Dynamic Time Resolved Perfusion

32 Monitoring Therapeutic Effects 95% RCA stenosis Stress Blood flow in defect: 65 cc/ 100 cc/ min Blood flow in healthy myocardium: 112 cc/ 100 cc/ min Rest Rotation time: 0.28 s Temporal resolution: 75 ms Tube voltage: 100 kv Prospectively triggered scans for 30 s Ho et al., Journal of Cardiovascular Computed Tomography, Vol 5, No 2, March/April 2011

33 Monitoring Therapeutic Effects Patent stent Stress Blood flow in former defect: 118 cc/ 100 cc/ min Blood flow in healthy myocardium: 112 cc/ 100 cc/ min Rest Ho et al., Journal of Cardiovascular Computed Tomography, Vol 5, No 2, March/April 2011 Rotation time: 0.28 s Temporal resolution: 75 ms Tube voltage: 100 kv Prospectively triggered scans for 30 s

34 Solving Clinical Dilemmas No stenosis Intermediate stenosis High grade stenosis Rule-out Rule-in Rule-out Dynamic Volumetric Stress MPI or DECT Stress/Rest MPI Discharge Discharge Cathlab Cathlab

35 F. Bamberg et al., Radiology 2011 Solving Clinical Dilemmas

36 Discriminator DECT Dynamic Perfusion Radiation dose Volume coverage Temporal resolution Ease of acquisition Ease of post processing Structural information Perfusion information Viability information Quantification

37 Summary Future Perspectives Promising developments for CT imaging of myocardial perfusion and delayed enhancement CT not the primary method for evaluation of myocardial perfusion CTA is mainly aimed at imaging the coronaries CT a possibly attractive modality for integrative imaging of anatomy and perfusion Further refinements in technique (e.g. area detector CT, dual energy CT)

38

CT Perfusion. U. Joseph Schoepf, MD, FAHA, FSCBT MR, FSCCT Professor of Radiology, Medicine, and Pediatrics Director of Cardiovascular Imaging

CT Perfusion. U. Joseph Schoepf, MD, FAHA, FSCBT MR, FSCCT Professor of Radiology, Medicine, and Pediatrics Director of Cardiovascular Imaging CT Perfusion U. Joseph Schoepf, MD, FAHA, FSCBT MR, FSCCT Professor of Radiology, Medicine, and Pediatrics Director of Cardiovascular Imaging Disclosures Consultant for / research support from Bayer Bracco

More information

CT Myocardial Perfusion: Is there Added Value to Coronary CT?

CT Myocardial Perfusion: Is there Added Value to Coronary CT? CT Myocardial Perfusion: Is there Added Value to Coronary CT? U. Joseph Schoepf, MD, FAHA, FSCBT MR, FSCCT Professor of Radiology, Medicine, and Pediatrics Director of Cardiovascular Imaging Disclosures

More information

MEDICAL UNIVERSITY of SOUTH CAROLINA

MEDICAL UNIVERSITY of SOUTH CAROLINA U. Joseph Schoepf, MD Prof. (h.c.), FAHA, FSCBT-MR, FNASCI, FSCCT Professor of Radiology, Medicine, and Pediatrics Director, Division of Cardiovascular Imaging MEDICAL UNIVERSITY of SOUTH CAROLINA Disclosures

More information

Cardiac CT Lowering the Dose Dramatically

Cardiac CT Lowering the Dose Dramatically Cardiac CT Lowering the Dose Dramatically U. Joseph Schoepf, MD, FAHA, FSCBT MR, FSCCT Professor of Radiology, Medicine, and Pediatrics Director of Cardiovascular Imaging Disclosures Consultant for / research

More information

Computer Aided Detection and Diagnosis: Cardiac Imaging Applications

Computer Aided Detection and Diagnosis: Cardiac Imaging Applications Computer Aided Detection and Diagnosis: Cardiac Imaging Applications U. Joseph Schoepf, MD, FAHA, FSCBT MR, FSCCT Professor of Radiology, Medicine, and Pediatrics Director of Cardiovascular Imaging Disclosures

More information

Dual Energy CT of Pulmonary Embolism

Dual Energy CT of Pulmonary Embolism Dual Energy CT of Pulmonary Embolism U. Joseph Schoepf, MD, FAHA, FSCBT MR, FSCCT Professor of Radiology, Medicine, and Pediatrics Director of Cardiovascular Imaging Disclosures Consultant for / research

More information

Computed Tomography of the Coronary Arteries

Computed Tomography of the Coronary Arteries Cardiology Update DAVOS 2011 Computed Tomography of the Coronary Arteries Anders Persson M.D., Ph.D Director, Assoc. Professor Center for Medical Image Science and Visualization Linköping University SWEDEN

More information

Validation of CT Perfusion Imaging Against Invasive Angiography and FFR on a 320-MDCT Scanner

Validation of CT Perfusion Imaging Against Invasive Angiography and FFR on a 320-MDCT Scanner Validation of CT Perfusion Imaging Against Invasive Angiography and FFR on a 320-MDCT Scanner Zhen Qian, Gustavo Vasquez, Sarah Rinehart, Parag Joshi, Eric Krivitsky, Anna Kalynych, Dimitri Karmpaliotis,

More information

Disclosure Information

Disclosure Information Coronary CTA Pearls and Pitfalls Ricardo C. Cury, MD, FSCCT, FAHA, FACC Chairman of Radiology Radiology Associates of South Florida Director of Cardiac Imaging Miami Cardiac and Vascular Institute Past-President

More information

Low Dose Era in Cardiac CT

Low Dose Era in Cardiac CT Low Dose Era in Cardiac CT DIANA E. LITMANOVICH, MD Department of Radiology Beth Israel Deaconess Medical Center Harvard Medical School Disclosures Neither I nor my immediate family members have a financial

More information

The radiation dose in retrospective

The radiation dose in retrospective The radiation dose in retrospective gated tdcoronary computed td tomography (CCT) Saeed AL Ahmari, Ghormallah AL Zahrani, Sumiah AL Helali, Samir AL Dulikan, Abdullah Bafagih, HibaKhashojji Prince Sultan

More information

Imaging ischemic heart disease: Role of CCTA

Imaging ischemic heart disease: Role of CCTA Plenary Session II Ischemic Heart Disease Imaging ischemic heart disease: Role of CCTA Florian Wolf Medical University of Vienna Department of Biomedical Imaging and Image Guided Therapy Division of Cardi0vascular

More information

University of Groningen. Quantitative CT myocardial perfusion Pelgrim, Gert

University of Groningen. Quantitative CT myocardial perfusion Pelgrim, Gert University of Groningen Quantitative CT myocardial perfusion Pelgrim, Gert IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check

More information

8/3/2016. Consultant for / research support from: Astellas Bayer Bracco GE Healthcare Guerbet Medrad Siemens Healthcare. Single Energy.

8/3/2016. Consultant for / research support from: Astellas Bayer Bracco GE Healthcare Guerbet Medrad Siemens Healthcare. Single Energy. U. Joseph Schoepf, MD Prof. (h.c.), FAHA, FSCBT-MR, FNASCI, FSCCT Professor of Radiology, Medicine, and Pediatrics Director, Division of Cardiovascular Imaging Consultant for / research support from: Astellas

More information

Combined Anatomical and Functional Imaging with Revolution * CT

Combined Anatomical and Functional Imaging with Revolution * CT GE Healthcare Case studies Combined Anatomical and Functional Imaging with Revolution * CT Jean-Louis Sablayrolles, M.D. Centre Cardiologique du Nord, Saint-Denis, France Case 1 Whole Brain Perfusion and

More information

An Introduction to Dual Energy Computed Tomography

An Introduction to Dual Energy Computed Tomography An Introduction to Dual Energy Computed Tomography Michael Riedel University of Texas Health Science Center at San Antonio Introduction The idea of computed tomography (CT) was first introduced in the

More information

Multisclice CT in combination with functional imaging for CAD. Temporal Resolution. Spatial Resolution. Temporal resolution = ½ of the rotation time

Multisclice CT in combination with functional imaging for CAD. Temporal Resolution. Spatial Resolution. Temporal resolution = ½ of the rotation time Multisclice CT in combination with functional imaging for CAD Prof. Juhani Knuuti, MD, FESC Turku University Hospital and University of Turku Turku, Finland MSCT and functional imaging for CAD Practical

More information

Use of Nuclear Cardiology in Myocardial Viability Assessment and Introduction to PET and PET/CT for Advanced Users

Use of Nuclear Cardiology in Myocardial Viability Assessment and Introduction to PET and PET/CT for Advanced Users Use of Nuclear Cardiology in Myocardial Viability Assessment and Introduction to PET and PET/CT for Advanced Users February 1 5, 2011 University of Santo Tomas Hospital Angelo King A-V Auditorium Manila,

More information

CT or PET/CT for coronary artery disease

CT or PET/CT for coronary artery disease CT or PET/CT for coronary artery disease Rotterdam 2012 Juhani Knuuti, MD, PhD, FESC Turku PET Centre University of Turku Turku, Finland Juhani.knuuti@utu.fi Turku PET Centre University of Turku Åbo Akademi

More information

Diagnostic and Prognostic Value of Coronary Ca Score

Diagnostic and Prognostic Value of Coronary Ca Score Diagnostic and Prognostic Value of Coronary Ca Score Dr. Ghormallah Alzahrani Cardiac imaging division, Adult Cardiology department Prince Sultan Cardiac Center ( PSCC) Madina, June 2 Coronary Calcium

More information

SPECT or PET for Cardiovascular Screening in High-Risk Patients

SPECT or PET for Cardiovascular Screening in High-Risk Patients SPECT or PET for Cardiovascular Screening in High-Risk Patients Paeng, Jin Chul MD PhD Department of Nuclear Medicine Seoul National University Hospital Contents Recent Development in SPECT and PET Technology

More information

Low-dose and High-resolution Cardiac Imaging with Revolution CT

Low-dose and High-resolution Cardiac Imaging with Revolution CT GE Healthcare Case study Low-dose and High-resolution Cardiac Imaging with Revolution CT Prof. Philipp A. Kaufmann, M.D. Ronny R. Buechel, M.D. Fran Mikulicic, M.D. Dominik C. Benz, M.D. University of

More information

Technology Assessment Institute: Summit on CT Dose Cardiac CT - Optimal Use of Evolving Scanner Technologies

Technology Assessment Institute: Summit on CT Dose Cardiac CT - Optimal Use of Evolving Scanner Technologies Cardiac CT - Optimal Use of Evolving Scanner Technologies P. Rogalla, M.D. Dept. of Medical Imaging University of Toronto Special thanks to Dr. Lembcke, Dr. Hein Charité, Berlin Disclosures No salaries

More information

Advanced Imaging MRI and CTA

Advanced Imaging MRI and CTA Advanced Imaging MRI and CTA Who and why may benefit. Matthew W. Martinez, M.D. FACC Lehigh Valley Health Network Director, Cardiovascular Imaging Learning Objectives Review basics of CMR and CTA Review

More information

Calcium scoring Clinical and prognostic value

Calcium scoring Clinical and prognostic value Calcium scoring Clinical and prognostic value Matthijs Oudkerk Professor and Chair of Radiology University Medical Center Groningen, University of Groningen Groningen, The Netherlands Sofia 2011 13 May

More information

Disclosures. GETTING TO THE HEART OF THE MATTER WITH MULTIMODALITY CARDIAC IMAGING Organ Review Meeting 25 September. Overview

Disclosures. GETTING TO THE HEART OF THE MATTER WITH MULTIMODALITY CARDIAC IMAGING Organ Review Meeting 25 September. Overview GETTING TO THE HEART OF THE MATTER WITH MULTIMODALITY CARDIAC IMAGING Organ Review Meeting 25 September Disclosures None relevant to this presentation Mini Pakkal Assistant Professor of Radiology University

More information

Imaging congestive heart failure: role of coronary computed tomography angiography (CCTA)

Imaging congestive heart failure: role of coronary computed tomography angiography (CCTA) Imaging congestive heart failure: role of coronary computed tomography angiography (CCTA) Gianluca Pontone, MD, PhD, FESC, FSCCT Director of MR Unit Deputy Director of Cardiovascul CT Unit Clinical Cardiology

More information

Cardiac Computed Tomography

Cardiac Computed Tomography Cardiac Computed Tomography Authored and approved by Koen Nieman Stephan Achenbach Francesca Pugliese Bernard Cosyns Patrizio Lancellotti Anastasia Kitsiou Contents CARDIAC COMPUTED TOMOGRAPHY Page 1.

More information

The Latest on CT Fractional Flow Reserve. Dimitris Mitsouras, Ph.D.

The Latest on CT Fractional Flow Reserve. Dimitris Mitsouras, Ph.D. The Latest on CT Fractional Flow Reserve Dimitris Mitsouras, Ph.D. Assistant Professor of Radiology Harvard Medical School Director, Applied Imaging Science Lab Brigham and Women s Hospital Disclosures

More information

Hybrid cardiac imaging Advantages, limitations, clinical scenarios and perspectives for the future

Hybrid cardiac imaging Advantages, limitations, clinical scenarios and perspectives for the future Hybrid cardiac imaging Advantages, limitations, clinical scenarios and perspectives for the future Prof. Juhani Knuuti, MD, FESC Turku, Finland Disclosure: Juhani Knuuti, M.D. Juhani Knuuti, M.D. has financial

More information

Pushing the limits of cardiac CT. Steven Dymarkowski Radiology / Medical Imaging Research Centre

Pushing the limits of cardiac CT. Steven Dymarkowski Radiology / Medical Imaging Research Centre Pushing the limits of cardiac CT Steven Dymarkowski Radiology / Medical Imaging Research Centre 5 X 2013 Introduction Rapid technological advances and new clinical applications in cardiovascular imaging

More information

Coronary Artery Imaging. Suvipaporn Siripornpitak, MD Inter-hospital Conference : Rajavithi Hospital

Coronary Artery Imaging. Suvipaporn Siripornpitak, MD Inter-hospital Conference : Rajavithi Hospital Coronary Artery Imaging Suvipaporn Siripornpitak, MD Inter-hospital Conference : Rajavithi Hospital Larger array : cover scan area Detector size : spatial resolution Rotation speed : scan time Retrospective

More information

Is computed tomography angiography really useful in. of coronary artery disease?

Is computed tomography angiography really useful in. of coronary artery disease? Is computed tomography angiography really useful in screening patients with high risk of coronary artery disease? Myeong-Ki Hong, M.D. Ph D Professor of Medicine Division of Cardiology, Severance Cardiovascular

More information

Nuclear Cardiology Cardiac Myocardial Perfusion with 82 Rb. Dominique Delbeke, MD, PhD Vanderbilt University Medical Center Nashville, TN

Nuclear Cardiology Cardiac Myocardial Perfusion with 82 Rb. Dominique Delbeke, MD, PhD Vanderbilt University Medical Center Nashville, TN Nuclear Cardiology Cardiac Myocardial Perfusion with 82 Rb Dominique Delbeke, MD, PhD Vanderbilt University Medical Center Nashville, TN VUMC PET/CT conference 2009 82 Rb Cardiac Perfusion PET 82 Rb is

More information

Cardiac CT Techniques in Neonates (and infants)

Cardiac CT Techniques in Neonates (and infants) Cardiac CT Techniques in Neonates (and infants) Siddharth P. Jadhav, MD Director, Body CT and MRI Edward B. Singleton Department of Pediatric Radiology Texas Children s Hospital Disclosures None Objectives

More information

Cardiopulmonary Imaging Original Research

Cardiopulmonary Imaging Original Research Cardiopulmonary Imaging Original Research De Cecco et al. Cardiopulmonary Imaging Original Research Carlo Nicola De Cecco 1,2 Brett S. Harris 1 U. Joseph Schoepf 1,3 Justin R. Silverman 1 Cullen B. McWhite

More information

CT of Coronary Heart Disease: Part 1, CT of Myocardial Infarction, Ischemia, and Viability

CT of Coronary Heart Disease: Part 1, CT of Myocardial Infarction, Ischemia, and Viability Cardiopulmonary Imaging Review Vliegenthart et al. CT of Coronary Heart Disease Cardiopulmonary Imaging Review CME SAM CT of Coronary Heart Disease FOCUS ON: Rozemarijn Vliegenthart 1,2 Thomas Henzler

More information

Conflict of Interest Disclosure

Conflict of Interest Disclosure Comparative Advantages of PET Over SPECT: Is PET Really Better? Timothy M. Bateman M.D. Co-Director, Cardiovascular Radiologic Imaging Mid America Heart Institute Professor of Medicine University of Missouri-Kansas

More information

CASE from South Korea

CASE from South Korea CASE from South Korea Bon-Kwon Koo, MD, PhD, Seoul, Korea Outpatient clinic of a non-interventional cardiologist F/56 Chief complaint: Angina with recent aggravation, CCS II~III Brief history: # Stroke

More information

Which Test When? Avoid the Stress of Stress Testing. Marc Newell, MD, FACC, FSCCT Minneapolis Heart Institute

Which Test When? Avoid the Stress of Stress Testing. Marc Newell, MD, FACC, FSCCT Minneapolis Heart Institute Which Test When? Avoid the Stress of Stress Testing Marc Newell, MD, FACC, FSCCT Minneapolis Heart Institute Outline Understand the importance of coronary artery disease assessment Understand the basics

More information

CT Myocardial Perfusion

CT Myocardial Perfusion 1 CT Myocardial Perfusion Ting-Yim Lee, PhD, FCCPM, FCOMP Aaron So, PhD, FSCCT Gerald Wisenberg, MD, FRCPC Ali Islam, MD, FRCPC Lawson Health Research Institute Robarts research Institute The University

More information

Ultrasound. Computed tomography. Case studies. Utility of IQon Spectral CT in. cardiac imaging

Ultrasound. Computed tomography. Case studies. Utility of IQon Spectral CT in. cardiac imaging Ultrasound Computed tomography Case studies Utility of IQon Spectral CT in cardiac imaging Cardiac imaging is a challenging procedure where it is necessary to image a motion-free heart. This requires a

More information

Pearls & Pitfalls in nuclear cardiology

Pearls & Pitfalls in nuclear cardiology Pearls & Pitfalls in nuclear cardiology Maythinee Chantadisai, MD., NM physician Division of Nuclear Medicine, Department of radiology, KCMH Principle of myocardial perfusion imaging (MPI) Radiotracer

More information

Accuracy of iodine quantification using dual energy CT in latest generation dual source and dual layer CT

Accuracy of iodine quantification using dual energy CT in latest generation dual source and dual layer CT Eur Radiol (2017) 27:3904 3912 DOI.07/s00330-017-472-9 CARDIAC Accuracy of iodine quantification using dual energy CT in latest generation dual source and dual layer CT Gert Jan Pelgrim 1 & Robbert W.

More information

Les Outils Cliniques de Demain en Scanner Cardiaque. Cardiaque Status en ECR 2018 From Diagnosis to Prognosis

Les Outils Cliniques de Demain en Scanner Cardiaque. Cardiaque Status en ECR 2018 From Diagnosis to Prognosis ECR 2018 From Diagnosis to Prognosis ECR 2018 From Diagnosis to Prognosis Thursday, March 1, 2018/08:30-10:00/Room N Les Outils Cliniques de Demain en Scanner Cardiaque Cardiaque Status en 2018 Rodrigo

More information

Non Invasive Diagnostic Modalities for Coronary Artery Disease. Dr. Amitesh Aggarwal

Non Invasive Diagnostic Modalities for Coronary Artery Disease. Dr. Amitesh Aggarwal Non Invasive Diagnostic Modalities for Coronary Artery Disease Dr. Amitesh Aggarwal Ebers papyrus, ca. 1555 BCE If thou examine a man for illness in his cardia, and he has pains in his arms, in his breasts

More information

Stress only Perfusion Imaging

Stress only Perfusion Imaging European Society of Cardiology Annual meeting, 2010, Stockholm, Sweden Stress only Perfusion Imaging Oliver Gaemperli, MD Cardiovascular Center, University Hospital Zurich, Switzerland Male patient, 48

More information

Physiologic Assessment by Cardiac CT

Physiologic Assessment by Cardiac CT Physiologic Assessment by Cardiac CT Mouaz Al-Mallah, MD MSc FACC Associate Professor of Medicine Division Head, Cardiac Imaging King Abdul-Aziz Cardiac Center National Guard Health Affairs Riyadh, Saudia

More information

Index. radiologic.theclinics.com. Note: Page numbers of article titles are in boldface type.

Index. radiologic.theclinics.com. Note: Page numbers of article titles are in boldface type. Index Note: Page numbers of article titles are in boldface type. A ALCAPA. See Anomalous left coronary artery from the pulmonary artery. Angiosarcoma computed tomographic assessment of, 809 811 Anomalous

More information

SPECT-CT: Τι πρέπει να γνωρίζει ο Καρδιολόγος

SPECT-CT: Τι πρέπει να γνωρίζει ο Καρδιολόγος SPECT-CT: Τι πρέπει να γνωρίζει ο Καρδιολόγος Δρ Αναστασία Κίτσιου Διευθύντρια, Καρδιολογική Κλινική, Σισμανόγλειο ΓΝΑ Chair, Education Committee, Section on Nuclear Cardiology & Cardiac CT, EACVI, ESC

More information

Fundamentals, Techniques, Pitfalls, and Limitations of MDCT Interpretation and Measurement

Fundamentals, Techniques, Pitfalls, and Limitations of MDCT Interpretation and Measurement Fundamentals, Techniques, Pitfalls, and Limitations of MDCT Interpretation and Measurement 3 rd Annual Imaging & Physiology Summit November 20-21, 21, 2009 Seoul, Korea Wm. Guy Weigold, MD, FACC Cardiovascular

More information

Dual-Energy CT: The Technological Approaches

Dual-Energy CT: The Technological Approaches Dual-Energy CT: The Technological Approaches Dushyant Sahani, M.D Director of CT Associate Professor of Radiology Massachusetts General Hospital Harvard Medical School Email-dsahani@partners.org Disclosure

More information

An Epidemic of Heart Disease The Silent Killer. Professor Mike Kirby FRCP University of Hertfordshire Institute of Diabetes for Older People

An Epidemic of Heart Disease The Silent Killer. Professor Mike Kirby FRCP University of Hertfordshire Institute of Diabetes for Older People An Epidemic of Heart Disease The Silent Killer Professor Mike Kirby FRCP University of Hertfordshire Institute of Diabetes for Older People Initial clinical presentation of CAD Angina MI Atypical CP Death

More information

Triple Rule-out using 320-row-detector volume MDCT: A comparison of the wide volume and helical modes

Triple Rule-out using 320-row-detector volume MDCT: A comparison of the wide volume and helical modes Triple Rule-out using 320-row-detector volume MDCT: A comparison of the wide volume and helical modes Poster No.: C-0488 Congress: ECR 2012 Type: Authors: Keywords: DOI: Scientific Exhibit E.-J. Kang,

More information

General Cardiovascular Magnetic Resonance Imaging

General Cardiovascular Magnetic Resonance Imaging 2 General Cardiovascular Magnetic Resonance Imaging 19 Peter G. Danias, Cardiovascular MRI: 150 Multiple-Choice Questions and Answers Humana Press 2008 20 Cardiovascular MRI: 150 Multiple-Choice Questions

More information

Current and Future Imaging Trends in Risk Stratification for CAD

Current and Future Imaging Trends in Risk Stratification for CAD Current and Future Imaging Trends in Risk Stratification for CAD Brian P. Griffin, MD FACC Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Disclosures: None Introduction

More information

Isolated congenital coronary anomalies: Evaluation by multislice-ct or MRI

Isolated congenital coronary anomalies: Evaluation by multislice-ct or MRI Isolated congenital coronary anomalies: Evaluation by multislice-ct or MRI B.K. Velthuis, Dept. of Radiology UMC Utrecht, the Netherlands ESC 2010 Coronary artery anomalies CAA Uncommon 0.3-5% normal population

More information

A Snapshot on Nuclear Cardiac Imaging

A Snapshot on Nuclear Cardiac Imaging Editorial A Snapshot on Nuclear Cardiac Imaging Khalil, M. Department of Physics, Faculty of Science, Helwan University. There is no doubt that nuclear medicine scanning devices are essential tool in the

More information

Myocardial blood flow quantification for evaluation of coronary artery disease by computed tomography

Myocardial blood flow quantification for evaluation of coronary artery disease by computed tomography Review Article Myocardial blood flow quantification for evaluation of coronary artery disease by computed tomography Filippo Cademartiri 1,2, Sara Seitun 3, Alberto Clemente 4, Ludovico La Grutta 5, Patrizia

More information

Computed Tomography Imaging of the Coronary Arteries

Computed Tomography Imaging of the Coronary Arteries Chapter 6 Computed Tomography Imaging of the Coronary Arteries G.J. Pelgrim, M. Oudkerk and R. Vliegenthart Additional information is available at the end of the chapter http://dx.doi.org/10.5772/54044

More information

Calcium scoring using 64-slice MDCT, dual source CT and EBT: a comparative phantom study

Calcium scoring using 64-slice MDCT, dual source CT and EBT: a comparative phantom study Int J Cardiovasc Imaging (2008) 24:547 556 DOI 10.1007/s10554-007-9282-0 ORIGINAL PAPER Calcium scoring using 64-slice MDCT, dual source CT and EBT: a comparative phantom study Jaap M. Groen Æ Marcel J.

More information

Alessandro Albonico Philips

Alessandro Albonico Philips Alessandro Albonico Philips Alessandro.albonico@philips.com Noise (Standard Deviation in HU) Virtually noise-free Characteristic of a true knowledge-based IR 80 70 Standard Recon idose4 Level6 1 mm Slice

More information

University of Groningen. Quantitative CT myocardial perfusion Pelgrim, Gert

University of Groningen. Quantitative CT myocardial perfusion Pelgrim, Gert University of Groningen Quantitative CT myocardial perfusion Pelgrim, Gert IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check

More information

True Dual Energy. Dr. Stefan Ulzheimer, Siemens Healthcare GmbH. DEfinitely Siemens

True Dual Energy. Dr. Stefan Ulzheimer, Siemens Healthcare GmbH. DEfinitely Siemens DEfinitely Siemens True Dual Energy Dr. Stefan Ulzheimer, Siemens Healthcare GmbH International version. Not for distribution in the US. Unrestricted Siemens AG 2015 All rights reserved. The products/features

More information

Imaging ischemic heart disease: role of SPECT and PET. Focus on Patients with Known CAD

Imaging ischemic heart disease: role of SPECT and PET. Focus on Patients with Known CAD Imaging ischemic heart disease: role of SPECT and PET. Focus on Patients with Known CAD Hein J. Verberne Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands International Conference

More information

The Value of Stress MRI in Evaluation of Myocardial Ischemia

The Value of Stress MRI in Evaluation of Myocardial Ischemia The Value of Stress MRI in Evaluation of Myocardial Ischemia Dr. Saeed Al Sayari, MBBS, EBCR, MBA Department of Radiology and Nuclear Medicine Mafraq Hospital, Abu Dhabi United Arab Emirates Introduction

More information

Beam hardening artifact reduction using dual energy computed tomography: implications for myocardial perfusion studies

Beam hardening artifact reduction using dual energy computed tomography: implications for myocardial perfusion studies Brief Report Beam hardening artifact reduction using dual energy computed tomography: implications for myocardial perfusion studies Gaston A. Rodriguez-Granillo 1, Patricia Carrascosa 1, Silvina Cipriano

More information

Horizon Scanning Technology Summary. Magnetic resonance angiography (MRA) imaging for the detection of coronary artery disease

Horizon Scanning Technology Summary. Magnetic resonance angiography (MRA) imaging for the detection of coronary artery disease Horizon Scanning Technology Summary National Horizon Scanning Centre Magnetic resonance angiography (MRA) imaging for the detection of coronary artery disease April 2007 This technology summary is based

More information

Combining Coronary Artery Calcium Scanning with SPECT/PET Myocardial Perfusion Imaging

Combining Coronary Artery Calcium Scanning with SPECT/PET Myocardial Perfusion Imaging Combining Coronary Artery Calcium Scanning with SPECT/PET Myocardial Perfusion Imaging Daniel S. Berman, MD Director, Cardiac Imaging Cedars-Sinai Heart Institute Professor of Medicine and Imaging Cedars-Sinai

More information

Cardiology for the Practitioner Advanced Cardiac Imaging: Worth the pretty pictures?

Cardiology for the Practitioner Advanced Cardiac Imaging: Worth the pretty pictures? Keenan Research Centre Li Ka Shing Knowledge Institute Cardiology for the Practitioner Advanced Cardiac Imaging: Worth the pretty pictures? Howard Leong-Poi, MD, FRCPC Associate Professor of Medicine St.

More information

Improvement of Image Quality with ß-Blocker Premedication on ECG-Gated 16-MDCT Coronary Angiography

Improvement of Image Quality with ß-Blocker Premedication on ECG-Gated 16-MDCT Coronary Angiography 16-MDCT Coronary Angiography Shim et al. 16-MDCT Coronary Angiography Sung Shine Shim 1 Yookyung Kim Soo Mee Lim Received December 1, 2003; accepted after revision June 1, 2004. 1 All authors: Department

More information

Potential recommendations for CT coronary angiography in athletes

Potential recommendations for CT coronary angiography in athletes Potential recommendations for CT coronary angiography in athletes B.K. Velthuis Dept. of Radiology UMC Utrecht, the Netherlands EuroPRevent 15 April 2011 Declaration of interest Philips Medical Systems

More information

Sung A Chang Department of Internal Medicine, Division of Cardiology, Sungkyunkwan University School of Medicine, Samsung Medical Center

Sung A Chang Department of Internal Medicine, Division of Cardiology, Sungkyunkwan University School of Medicine, Samsung Medical Center CMR Perfusion and Viability A STICH Out of Time? Sung A Chang Department of Internal Medicine, Division of Cardiology, Sungkyunkwan University School of Medicine, Samsung Medical Center Can Imaging Improve

More information

Dual-Energy 101: Principles, Methods and Dose

Dual-Energy 101: Principles, Methods and Dose Dual-Energy 101: Principles, Methods and Dose Juan Carlos Ramirez-Giraldo, Ph.D Staff Scien2st, Collabora2ons Manager SE Region ISCT San Francisco, 2017 Siemens Medical Solu2ons USA, Inc., 2017 Page 1

More information

CARDIAC IMAGING FOR SUBCLINICAL CAD

CARDIAC IMAGING FOR SUBCLINICAL CAD CARDIAC IMAGING FOR SUBCLINICAL CAD WHY DON'T YOU ADOPT MORE SMART TECHNIQUE? Whal Lee, M.D. Seoul National University Hospital Department of Radiology We are talking about Coronary artery Calcium scoring,

More information

Noncoronary Cardiac MDCT

Noncoronary Cardiac MDCT Noncoronary Cardiac MDCT David A. Bluemke, M.D., Ph.D. Professor, of Radiology and Medicine Johns Hopkins University School of Medicine Baltimore, Maryland Toshiba Disclosures Grant support Noncoronary

More information

Cardiac CT Angiography

Cardiac CT Angiography Cardiac CT Angiography Dr James Chafey, Radiologist Why do we need a better test for C.A.D? 1. CAD is the leading cause of death in the US CAD 31% Cancer 23% Stroke 7% 2. The prevalence of atherosclerosis

More information

128-slice dual-source CT coronary angiography using highpitch scan protocols in 102 patients

128-slice dual-source CT coronary angiography using highpitch scan protocols in 102 patients 128-slice dual-source CT coronary angiography using highpitch scan protocols in 102 patients Poster No.: C-0634 Congress: ECR 2010 Type: Scientific Exhibit Topic: Cardiac Authors: Y. H. Choe, J. W. Lee,

More information

MD F A F C A C MAS A N S C

MD F A F C A C MAS A N S C Myocardial Perfusion Imaging and Coronary Calcium Scoring: Complimentary or Competitive David Wolinsky MD FACC MASNC Section Head Nuclear Cardiology, Cleveland Clinic Florida Immediate Past President,

More information

I have no financial disclosures

I have no financial disclosures Manpreet Singh MD I have no financial disclosures Exercise Treadmill Bicycle Functional capacity assessment Well validated prognostic value Ischemic assessment ECG changes ST segments Arrhythmias Hemodynamic

More information

Hospital, 6 Lukon Road, Lukong Town, Changhua Shien, Taiwan 505, Taiwan.

Hospital, 6 Lukon Road, Lukong Town, Changhua Shien, Taiwan 505, Taiwan. Volume 1, Issue 1 Image Article Resolution of Inferior Wall Ischemia after Successful Revascularization of LAD Lesion: The Value of Myocardial Perfusion Imaging in Guiding Management of Multi-vessel CAD

More information

New Technologies for Cardiac CT. Geoffrey D. Rubin, MD, MBA, FACR, FNASCI Duke University

New Technologies for Cardiac CT. Geoffrey D. Rubin, MD, MBA, FACR, FNASCI Duke University 1996 New Technologies for Cardiac CT Geoffrey D. Rubin, MD, MBA, FACR, FNASCI Duke University New Technology The Long View Levels of Efficacy Endpoint Examples 1: Technical Imaging resolution 2: Diagnostic

More information

Perfusion, Viability, Edema and Hemorrhage: How it Can (and Should) Change Clinical Practice. Rohan Dharmakumar, Ph.D.

Perfusion, Viability, Edema and Hemorrhage: How it Can (and Should) Change Clinical Practice. Rohan Dharmakumar, Ph.D. Perfusion, Viability, Edema and Hemorrhage: How it Can (and Should) Change Clinical Practice Rohan Dharmakumar, Ph.D. Director, Translational Cardiac Imaging Research Associate Director, Biomedical Imaging

More information

Usefulness of New CT Technologies for Interventional Cardiovascular Procedures

Usefulness of New CT Technologies for Interventional Cardiovascular Procedures Usefulness of New CT Technologies for Interventional Cardiovascular Procedures Ronen Rubinshtein, MD FACC FESC Department of Cardiovascular Medicine Lady Davis Carmel Medical Center & Technion Israel Institute

More information

Cardiac CT - Coronary Calcium Basics Workshop II (Basic)

Cardiac CT - Coronary Calcium Basics Workshop II (Basic) Cardiac CT - Coronary Calcium Basics Workshop II (Basic) J. Jeffrey Carr, MD, MSCE Dept. of Radiology & Public Health Sciences Wake Forest University School of Medicine Winston-Salem, NC USA No significant

More information

PET myocard perfusion & viability Riemer Slart

PET myocard perfusion & viability Riemer Slart PET myocard perfusion & viability Riemer Slart Nuclear Medicine Physician Dept. of Nuclear Medicine and Molecular Imaging University Medical Center Groningen, the Netherlands Professor in Molecular Imaging,

More information

Testing the Asymptomatic CAD Patient: When and Why?

Testing the Asymptomatic CAD Patient: When and Why? Testing the Asymptomatic CAD Patient: When and Why? Timothy M. Bateman M.D. Co-Director, Cardiovascular Radiologic Imaging Mid America Heart Institute Professor of Medicine University of Missouri-Kansas

More information

A new method for radiation dose reduction at cardiac CT with multi-phase data-averaging and non-rigid image registration: preliminary clinical trial

A new method for radiation dose reduction at cardiac CT with multi-phase data-averaging and non-rigid image registration: preliminary clinical trial A new method for radiation dose reduction at cardiac CT with multi-phase data-averaging and non-rigid image registration: preliminary clinical trial Poster No.: C-0595 Congress: ECR 2013 Type: Authors:

More information

Low-dose prospective ECG-triggering dual-source CT angiography in infants and children with complex congenital heart disease: first experience

Low-dose prospective ECG-triggering dual-source CT angiography in infants and children with complex congenital heart disease: first experience Low-dose prospective ECG-triggering dual-source CT angiography in infants and children with complex congenital heart disease: first experience Ximing Wang, M.D., Zhaoping Cheng, M.D., Dawei Wu, M.D., Lebin

More information

Banding and Step-Stair Artifacts on the Cardiac-CT Caused By Pseudo-Ectopic Beats

Banding and Step-Stair Artifacts on the Cardiac-CT Caused By Pseudo-Ectopic Beats Banding and Step-Stair Artifacts on the Cardiac-CT Caused By Pseudo-Ectopic Beats Amolak Singh 1*, Yash Sethi 1, Sonya Watkins 1, Angela Youtsey 1, Angie Thomas 1 1. Department of Radiology, University

More information

Optimal Method for Stenosis Assessment with CT

Optimal Method for Stenosis Assessment with CT Optimal Method for Stenosis Assessment with CT Jonathon Leipsic MD FRCPC FSCCT ViceChairman ofradiologyubc Disclosures Speaker s bureau: GE Healthcare and Edwards LifeSciences Grant Support CIHR, GE Healthcare

More information

NUCLEAR CARDIOLOGY UPDATE

NUCLEAR CARDIOLOGY UPDATE Nuclear Cardiology David K. Shelton, Jr., MD NUCLEAR CARDIOLOGY UPDATE No Conflicts. No Disclosures. No Smoking. David K. Shelton UCDMC Nuclear Cardiology Nuclear Cardiology Radionuclide Ventriculography

More information

Integrated PET/CT systems State of the art and Clinical Applications

Integrated PET/CT systems State of the art and Clinical Applications Integrated PET/CT systems State of the art and Clinical Applications V. Bettinardi Nuclear Medicine Dep. Scientific Institute San Raffaele Hospital Milan Italy The announcement of a new Diagnostic Imaging

More information

Original Article Application of flash dual-source CT at low radiation dose and low contrast medium dose in triple-rule-out (tro) examination

Original Article Application of flash dual-source CT at low radiation dose and low contrast medium dose in triple-rule-out (tro) examination Int J Clin Exp Med 2015;8(11):21898-21905 www.ijcem.com /ISSN:1940-5901/IJCEM0015005 Original Article Application of flash dual-source CT at low radiation dose and low contrast medium dose in triple-rule-out

More information

Radiation Dose Reduction Strategies in Coronary CT Angiography

Radiation Dose Reduction Strategies in Coronary CT Angiography Radiation Dose Reduction Strategies in Coronary CT Angiography Noor Diyana Osman, PhD noordiyana@usm.my Contents: Introduction Radiation dosimetry in CT Radiation risk associated with coronary CT angiography

More information

Fellows on this rotation are expected to attend nuclear conferences and multimodality imaging conference.

Fellows on this rotation are expected to attend nuclear conferences and multimodality imaging conference. Rotation: Imaging 1 Imaging 1 provides COCATS Level 1 experience for nuclear cardiology (including SPECT and PET) and cardiac CT. Fellows will administer, process, and read cardiac nuclear studies with

More information

Optimal testing for coronary artery disease in symptomatic and asymptomatic patients

Optimal testing for coronary artery disease in symptomatic and asymptomatic patients Optimal testing for coronary artery disease in symptomatic and asymptomatic patients Alexandre C Ferreira, MD Clinical Chief of Cardiology Jackson Health System Director, Interventional Cardiology Training

More information

Managing Radiation Risk in Pediatric CT Imaging

Managing Radiation Risk in Pediatric CT Imaging Managing Radiation Risk in Pediatric CT Imaging Mahadevappa Mahesh, MS, PhD, FAAPM, FACR, FACMP, FSCCT. Professor of Radiology and Cardiology Johns Hopkins University School of Medicine Chief Physicist

More information

Medical Policy An independent licensee of the Blue Cross Blue Shield Association

Medical Policy An independent licensee of the Blue Cross Blue Shield Association Contrast-Enhanced Coronary Computed Tomography Angiography (CCTA) Page 1 of 27 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Contrast-Enhanced Coronary Computed

More information

EXPERIMENTAL AND THERAPEUTIC MEDICINE 9: , 2015

EXPERIMENTAL AND THERAPEUTIC MEDICINE 9: , 2015 2384 Dose study of electrocardiogram automatic tube current modulation technology in prospective coronary computed tomography angiography scans of overweight patients GUIRU HE, XIAOPEI LIU, YAN LIU, WEI

More information