Dynamic CT Myocardial Perfusion Imaging

Study Overview
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Brief Summary
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This study aims at evaluating the feasibility of CT myocardial perfusion imaging in daily clinical practice and compare it to SPECT perfusion imaging in order to assess sensitivity and specifity of CT myocardial perfusion imaging compared to SPECT.

Detailed Description
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If after the clinically indicated CCTA a myocardial perfusion examination is indicated, first a single ultra low dose CT scan will be performed to look for late enhancement of potentially scarred myocardium. Together with the contrast agent co-injection of the clinically indicated tracer 99mTc-Tetrofosmin will be performed for later scintigraphic perfusion evaluation. After stress perfusion imaging CT rest perfusion imaging will be performed in a similar fashion. After acquisition of CT rest perfusion images scintigraphic stress and rest image acquisition will be performed as in daily clinical routine with an additional administration of 99mTc-Tetrofosmin resting dose if necessary. CT stress and rest perfusion will be compared to the clinically indicated and well established SPECT examination.

Official Title
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Diagnostic Value and Practicability of Dynamic CT Stress and Rest Myocardial Perfusion Imaging in Daily Clinical Practice - A Monocentric Prospective Diagnostic Study

Conditions
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Coronary Artery Disease

Intervention / Treatment
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* Other: CT-MPI and SPECT-MPI


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Referral for cardiac hybrid imaging with CCTA and SPECT Male and Female subjects 18 years of age or older, Written informed consent by the participant after information about the project Exclusion Criteria: Contraindications for CCTA (including renal failure with a GFR <60ml/min/1.73m2, allergies to ionidated constrast agents) Inability to follow the examination procedure due to language barriers, mental disease, dementia etc. Pregnancy or breast feeding Known allergies to iodinated contrast agent (Visipaque ®), 99mTc-Tetrofosmin (Myoview ®), betablockers (Beloc i.v. ®) or nitrates (Isoket -Spray®) Hypersensitivity to adenosine Asthma bronchiale

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: CTP and SPECT-MPI<br>Every patient enrolled will undergo CT-MPI and SPECT-MPI. The latter is clinically indicated,. | Other: CT-MPI and SPECT-MPI<br>* All patients undergo CT-MPI plus SPECT-MPI<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Validation of CT-MPI against SPECT-MPI | Sensitivity and specificity of CT-MPI to diagnose obstructive coronary artery disease using SPECTR-MPI as the standard reference | 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Parameters influencing image quality of CT-MPI - Body physique | Correlation between visually assessed image quality of CT-MPI and patient's body mass index | 2 years | 
| Parameters influencing image quality of CT-MPI - Heart rate | Correlation between visually assessed image quality of CT-MPI and patient's heart rate during the scan | 2 years |