Specific Aim 1: To study the diagnostic accuracy of stress CT perfusion As mentioned, CT scanners can acquire high quality images of the coronary arteries. CT coronary angiography has high diagnostic accuracy in the great majority of patients but may not have sufficient resolution or image quality to assess the patency of coronary stents and some heavily calcified vessels. Using CT to image stress myocardial perfusion could help solve the diagnostic uncertainty in those special subsets of patients. In addition, while high resolution overall, the resolution of a CT scan for grading the severity of a coronary stenosis in a 3 mm artery is still marginal. This is another area where CT stress perfusion could provide the physiologic assessments needed to help determine whether an anatomic stenosis is severe enough to have caused ischemia or warrant intervention. To address these issues, we have studied 58 patients as part of the multicenter Core320 study which compares CT coronary angiography/ stress CT perfusion with quantitative invasive coronary angiography/SPECT perfusion. We were the leading US recruitment site for this study which recently closed enrollment. Results are pending. In addition, we are leading an ancillary study that includes comparison of CT perfusion with stress MRI perfusion. That ancillary study has also completed enrollment and is under analysis.
Specific Aim 2 : To develop low dose cardiac CT imaging protocols that retain high diagnostic accuracy. Another pressing research direction has been developing low radiation dose CT scans of the heart. The public and academic medical communities have both realized that radiation exposure from diagnostic imaging is increasing at a rapid pace and may be associated with some health risks. Thus, finding methods for reducing radiation exposure in CT scans of the heart is a significant priority. To the best of our knowledge, the NHLBI cardiac CT program has the lowest average radiation exposure of any site using the 320 detector CT scanner. We are leading an assessing even lower dose CT imaging protocols. Preliminary results have been presented at National meetings and are in the process of being written.

Project Start
Project End
Budget Start
Budget End
Support Year
3
Fiscal Year
2013
Total Cost
$1,246,145
Indirect Cost
Name
National Heart, Lung, and Blood Institute
Department
Type
DUNS #
City
State
Country
Zip Code
Kühl, Jørgen Tobias; George, Richard T; Mehra, Vishal C et al. (2015) Endocardial-epicardial distribution of myocardial perfusion reserve assessed by multidetector computed tomography in symptomatic patients without significant coronary artery disease: insights from the CORE320 multicentre study. Eur Heart J Cardiovasc Imaging :
Fuchs, Andreas; Kühl, J Tobias; Chen, Marcus Y et al. (2015) Feasibility of coronary calcium and stent image subtraction using 320-detector row CT angiography. J Cardiovasc Comput Tomogr 9:393-8
Sharma, Ravi K; Arbab-Zadeh, Armin; Kishi, Satoru et al. (2015) Incremental diagnostic accuracy of computed tomography myocardial perfusion imaging over coronary angiography stratified by pre-test probability of coronary artery disease and severity of coronary artery calcification: The CORE320 study. Int J Cardiol 201:570-577
van der Pals, Jesper; Hammer-Hansen, Sophia; Nielles-Vallespin, Sonia et al. (2015) Temporal and spatial characteristics of the area at risk investigated using computed tomography and T1-weighted magnetic resonance imaging. Eur Heart J Cardiovasc Imaging :
Sen, Shurjo K; Boelte, Kimberly C; Barb, Jennifer J et al. (2014) Integrative DNA, RNA, and protein evidence connects TREML4 to coronary artery calcification. Am J Hum Genet 95:66-76
Sen, Shurjo K; Barb, Jennifer J; Cherukuri, Praveen F et al. (2014) Identification of candidate genes involved in coronary artery calcification by transcriptome sequencing of cell lines. BMC Genomics 15:198
Rochitte, Carlos E; George, Richard T; Chen, Marcus Y et al. (2014) Computed tomography angiography and perfusion to assess coronary artery stenosis causing perfusion defects by single photon emission computed tomography: the CORE320 study. Eur Heart J 35:1120-30
Chen, Marcus Y; Bandettini, W Patricia; Shanbhag, Sujata M et al. (2014) Concordance and diagnostic accuracy of vasodilator stress cardiac MRI and 320-detector row coronary CTA. Int J Cardiovasc Imaging 30:109-19
George, Richard T; Mehra, Vishal C; Chen, Marcus Y et al. (2014) Myocardial CT perfusion imaging and SPECT for the diagnosis of coronary artery disease: a head-to-head comparison from the CORE320 multicenter diagnostic performance study. Radiology 272:407-16
Chen, Marcus Y; Shanbhag, Sujata M; Arai, Andrew E (2013) Submillisievert median radiation dose for coronary angiography with a second-generation 320-detector row CT scanner in 107 consecutive patients. Radiology 267:76-85

Showing the most recent 10 out of 16 publications