Added Value of Transluminal Attenuation Gradient to Qualitative CCTA Ischemia Detection as Determined by <sup>13</sup>N-ammonia PET Quantitative Myocardial Perfusion
Transluminal attenuation gradient (TAG) represents the slope of intraluminal contrast that decreases along a coronary vessel during coronary computed tomography angiography (CCTA). The aim of this study was to determine the added value of TAG to qualitative CCTA assessment of significant stenosis (&...
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MDPI AG
2020-08-01
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Online Access: | https://www.mdpi.com/2075-4418/10/9/628 |
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author | Andrea Monroy-Gonzalez Erick Alexanderson-Rosas Oscar Perez-Orpinel Magdalena Dobrolinska Rene Tio Jan Cees de Groot Riemer Slart Niek Prakken |
author_facet | Andrea Monroy-Gonzalez Erick Alexanderson-Rosas Oscar Perez-Orpinel Magdalena Dobrolinska Rene Tio Jan Cees de Groot Riemer Slart Niek Prakken |
author_sort | Andrea Monroy-Gonzalez |
collection | DOAJ |
description | Transluminal attenuation gradient (TAG) represents the slope of intraluminal contrast that decreases along a coronary vessel during coronary computed tomography angiography (CCTA). The aim of this study was to determine the added value of TAG to qualitative CCTA assessment of significant stenosis (>50%) detecting ischemia as determined by stress myocardial blood flow (MBF) or myocardial flow reserve (MFR) measured by positron emission tomography (PET). Individual contributions of TAG, qualitative assessment and the impact of calcium score were also investigated. Methods: We studied 38 consecutive patients that were referred due to suspected or known coronary artery disease (CAD). All patients underwent a two-phase hybrid <sup>13</sup>N-ammonia PET/CT and CCTA. Results: TAG and presence of qualitatively assessed significant stenosis, but not calcium score, were associated with stress myocardial blood flow (MBF) and myocardial flow reserve (MFR). The area under the curves (AUC) of the linear predictor model including qualitative assessment and TAG was superior to the AUC of separate qualitative assessment or TAG for the detection of ischemia according to stress MBF (AUCs were: 88% vs. 79% and 77%; <i>p</i> = 0.01 and <i>p</i> = 0.01, respectively). Conclusions: TAG combined with qualitative CCTA assessment improved ischemia detection. |
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issn | 2075-4418 |
language | English |
last_indexed | 2024-03-10T16:55:26Z |
publishDate | 2020-08-01 |
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spelling | doaj.art-eb62bd884b7d423faad49e0c751c9b762023-11-20T11:09:59ZengMDPI AGDiagnostics2075-44182020-08-0110962810.3390/diagnostics10090628Added Value of Transluminal Attenuation Gradient to Qualitative CCTA Ischemia Detection as Determined by <sup>13</sup>N-ammonia PET Quantitative Myocardial PerfusionAndrea Monroy-Gonzalez0Erick Alexanderson-Rosas1Oscar Perez-Orpinel2Magdalena Dobrolinska3Rene Tio4Jan Cees de Groot5Riemer Slart6Niek Prakken7Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City 14080, MexicoDepartment of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City 14080, MexicoDepartment of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Cardiology, Catharina Hospital Eindhoven, 5623 EJ Eindhoven, The NetherlandsDepartment of Radiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Radiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsTransluminal attenuation gradient (TAG) represents the slope of intraluminal contrast that decreases along a coronary vessel during coronary computed tomography angiography (CCTA). The aim of this study was to determine the added value of TAG to qualitative CCTA assessment of significant stenosis (>50%) detecting ischemia as determined by stress myocardial blood flow (MBF) or myocardial flow reserve (MFR) measured by positron emission tomography (PET). Individual contributions of TAG, qualitative assessment and the impact of calcium score were also investigated. Methods: We studied 38 consecutive patients that were referred due to suspected or known coronary artery disease (CAD). All patients underwent a two-phase hybrid <sup>13</sup>N-ammonia PET/CT and CCTA. Results: TAG and presence of qualitatively assessed significant stenosis, but not calcium score, were associated with stress myocardial blood flow (MBF) and myocardial flow reserve (MFR). The area under the curves (AUC) of the linear predictor model including qualitative assessment and TAG was superior to the AUC of separate qualitative assessment or TAG for the detection of ischemia according to stress MBF (AUCs were: 88% vs. 79% and 77%; <i>p</i> = 0.01 and <i>p</i> = 0.01, respectively). Conclusions: TAG combined with qualitative CCTA assessment improved ischemia detection.https://www.mdpi.com/2075-4418/10/9/628transluminal attenuation gradientpositron emission tomographycoronary computed tomography angiographymyocardial blood flowcoronary artery disease |
spellingShingle | Andrea Monroy-Gonzalez Erick Alexanderson-Rosas Oscar Perez-Orpinel Magdalena Dobrolinska Rene Tio Jan Cees de Groot Riemer Slart Niek Prakken Added Value of Transluminal Attenuation Gradient to Qualitative CCTA Ischemia Detection as Determined by <sup>13</sup>N-ammonia PET Quantitative Myocardial Perfusion Diagnostics transluminal attenuation gradient positron emission tomography coronary computed tomography angiography myocardial blood flow coronary artery disease |
title | Added Value of Transluminal Attenuation Gradient to Qualitative CCTA Ischemia Detection as Determined by <sup>13</sup>N-ammonia PET Quantitative Myocardial Perfusion |
title_full | Added Value of Transluminal Attenuation Gradient to Qualitative CCTA Ischemia Detection as Determined by <sup>13</sup>N-ammonia PET Quantitative Myocardial Perfusion |
title_fullStr | Added Value of Transluminal Attenuation Gradient to Qualitative CCTA Ischemia Detection as Determined by <sup>13</sup>N-ammonia PET Quantitative Myocardial Perfusion |
title_full_unstemmed | Added Value of Transluminal Attenuation Gradient to Qualitative CCTA Ischemia Detection as Determined by <sup>13</sup>N-ammonia PET Quantitative Myocardial Perfusion |
title_short | Added Value of Transluminal Attenuation Gradient to Qualitative CCTA Ischemia Detection as Determined by <sup>13</sup>N-ammonia PET Quantitative Myocardial Perfusion |
title_sort | added value of transluminal attenuation gradient to qualitative ccta ischemia detection as determined by sup 13 sup n ammonia pet quantitative myocardial perfusion |
topic | transluminal attenuation gradient positron emission tomography coronary computed tomography angiography myocardial blood flow coronary artery disease |
url | https://www.mdpi.com/2075-4418/10/9/628 |
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