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

Ludovico La Grutta, Patrizia Toia, Massimo Midiri, Alberto Clemente, Erica Maffei, Sara Seitun, Giuseppe Runza, Filippo Cademartiri, Giuseppe Runza

Research output: Contribution to journalArticle

14 Citations (Scopus)


During the last decade coronary computed tomography angiography (CTA) has become the preeminent noninvasive imaging modality to detect coronary artery disease (CAD) with high accuracy. However, CTA has a limited value in assessing the hemodynamic significance of a given stenosis due to a modest specificity and positive predictive value. In recent years, different CT techniques for detecting myocardial ischemia have emerged, such as CT-derived fractional flow reserve (FFR-CT), transluminal attenuation gradient (TAG), and myocardial CT perfusion (CTP) imaging. Myocardial CTP imaging can be performed with a single static scan during first pass of the contrast agent, with monoenergetic or dual-energy acquisition, or as a dynamic, time-resolved scan during stress by using coronary vasodilator agents (adenosine, dipyridamole, or regadenoson). A number of CTP techniques are available, which can assess myocardial perfusion in both a qualitative, semi-quantitative or quantitative manner. Once used primarily as research tools, these modalities are increasingly being used in routine clinical practice. All these techniques offer the substantial advantage of combining anatomical and functional evaluation of flow-limiting coronary stenosis in the same examination that would be beneficial for clinical decision-making. This review focuses on the state-of the-art and future trends of these evolving imaging modalities in the field of cardiology for the physiologic assessments of CAD.
Original languageEnglish
Pages (from-to)129-150
Number of pages22
JournalCardiovascular Diagnosis and Therapy
Publication statusPublished - 2017

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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