Incremental value of dual-energy CT to coronary CT angiography for the detection of significant coronary stenosis: comparison with quantitative coronary angiography and single photon emission computed tomography

Int J Cardiovasc Imaging. 2011 Jun;27(5):647-56. doi: 10.1007/s10554-011-9881-7. Epub 2011 May 6.


To determine the value of dual-energy CT (DECT) and combined information of perfusion and angiography in diagnosing coronary artery disease (CAD), with single photon emission computed tomography (SPECT) and quantitative coronary angiography (QCA) as a reference standard. Thirty-four patients were enrolled in this study. DECT was used as a contrast-enhanced retrospectively ECG-gated scan protocol during the rest state and tubes were set at 140/100 kV. DECT angiography (DE-CTA) and DECT perfusion (DE-CTP) were calculated from two kV images. DE-CTP results were compared with SPECT and DE-CTA with QCA, respectively. The combined DE-CTP with DE-CTA data were compared to QCA in diagnosis of obstructive CAD (stenosis ≥ 50%). DECT showed diagnostic image quality in 31 patients. Using SPECT as a reference, DE-CTP had sensitivity of 68%, specificity of 93%, and sensitivity of 81%, and specificity of 92% for identifying any type of perfusion deficits on the segment- and territory-based analysis, respectively. Using QCA as a reference standard, DE-CTA showed sensitivity of 82%, specificity of 91% and accuracy of 86% for detecting ≥50% coronary stenosis on the vessel-based analysis, whereas the combination of DE-CTA and DE-CTP gave sensitivity of 90%, specificity of 86% and accuracy of 88% for detecting ≥50% coronary stenosis, respectively. Combination of DE-CTP and DE-CTA may improve diagnostic performance compared to CTA alone for the diagnosis of significant coronary stenosis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • China
  • Coronary Angiography / methods*
  • Coronary Circulation
  • Coronary Stenosis / diagnostic imaging*
  • Coronary Stenosis / physiopathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Perfusion Imaging / methods*
  • Predictive Value of Tests
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Tomography, Emission-Computed, Single-Photon*
  • Tomography, X-Ray Computed*