Myocardial computed tomography perfusion

Coronary computed tomography angiography (CTA) has a high sensitivity to rule out obstructive coronary artery disease (CAD), though its specificity to identify myocardial ischemia is only modest, mostly due to the lower positive predictive value of obstructive lesions detected by coronary CTA (1). The lower specificity of CTA has contributed to a higher rate of downstream invasive coronary angiography (ICA) and coronary revascularization in patients undergoing coronary CTA versus functional testing, despite uncertain clinical benefit of such procedures (2-4). Although recent studies suggest coronary CTA may result in improved outcomes, the overall ICA and revascularizations rates remains higher than desired (4,5)