Rationale and design of the PERFECTION (comparison between stress cardiac computed tomography PERfusion versus Fractional flow rEserve measured by Computed.

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Rationale and design of the PERFECTION (comparison between stress cardiac computed tomography PERfusion versus Fractional flow rEserve measured by Computed Tomography angiography In the evaluation of suspected cOroNary artery disease) prospective study Gianluca Pontone, Daniele Andreini, Andrea I. Guaricci, Marco Guglielmo, Saima Mushtaq, Andrea Baggiano, Virginia Beltrama, Daniela Trabattoni, Cristina Ferrari, Giuseppe Calligaris, Giovanni Teruzzi, Franco Fabbiocchi, Alessandro Lualdi, Piero Montorsi, Antonio L. Bartorelli, Mauro Pepi Journal of Cardiovascular Computed Tomography Volume 10, Issue 4, Pages 330-334 (July 2016) DOI: 10.1016/j.jcct.2016.03.004 Copyright © 2016 Society of Cardiovascular Computed Tomography Terms and Conditions

Fig. 1 PERFECTION study workflow. CTP: computed tomography perfusion; FFR: fractional flow reserve; FFRCT: fractional flow reserve measured by computed tomography angiography; ICA: invasive coronary angiography; MBF: myocardial blood flow, TPR: transmural perfusion ratio. Journal of Cardiovascular Computed Tomography 2016 10, 330-334DOI: (10.1016/j.jcct.2016.03.004) Copyright © 2016 Society of Cardiovascular Computed Tomography Terms and Conditions

Fig. 2 FFRCT analyses. From a standard CTA (Panel A), a quantitative 3-dimensional anatomic model of coronary arteries will be generated. (B). A physiological model of the coronary microcirculation will be derived from patient-specific characteristics and physical laws of fluid dynamics will be applied (C) to calculate FFRCT for each point in the coronary tree (D). CTA: cardiac computed tomography angiography; FFRCT: fractional flow reserve measured by computed tomography; LAD: left anterior descending coronary artery; LCx: left circumflex coronary artery; RCA: right coronary artery. Journal of Cardiovascular Computed Tomography 2016 10, 330-334DOI: (10.1016/j.jcct.2016.03.004) Copyright © 2016 Society of Cardiovascular Computed Tomography Terms and Conditions

Fig. 3 Rest CTA plus myocardial CTP protocol. See “Technical methods” section for further detail. CTA: cardiac computed tomography angiography; CTP: computed tomography perfusion. Journal of Cardiovascular Computed Tomography 2016 10, 330-334DOI: (10.1016/j.jcct.2016.03.004) Copyright © 2016 Society of Cardiovascular Computed Tomography Terms and Conditions