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Combined Non-invasive Coronary Angiography and Myocardial Perfusion Imaging Using 320 Detector Computed Tomography (Core320)

Primary Purpose

Arterial Occlusive Diseases, Coronary Disease, Heart Diseases

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
320 Volume Detector Computed Tomography
Other: Multidetector Computed Tomography - 320 detectors
Sponsored by
Johns Hopkins University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Arterial Occlusive Diseases focused on measuring Coronary Artery Disease, Computed Tomography, Myoperfusion, Angiography, SPECT

Eligibility Criteria

45 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Male or female patients, age 45-85. Women of child bearing potential must demonstrate a negative pregnancy test within 24 hours of the study MDCT.
  • Suspected or diagnosed coronary artery disease with a clinical indication for coronary angiography; and planned coronary angiography within the next 60 days.
  • Able to understand and willing to sign the Informed Consent Form.

Exclusion Criteria:

  • Known allergy to iodinated contrast media.
  • History of contrast-induced nephropathy.
  • History of multiple myeloma or previous organ transplantation.
  • Elevated serum creatinine (> 1.5 mg/dl) OR calculated creatinine clearance of < 60 ml/min (using the Cockcroft-Gault formula.
  • Atrial fibrillation or uncontrolled tachyarrhythmia, or advanced atrioventricular block (second or third degree heart block).
  • Evidence of severe symptomatic heart failure (NYHA Class III or IV); Known or suspected moderate or severe aortic stenosis.
  • Previous coronary artery bypass or other cardiac surgery.
  • Coronary artery intervention within the last 6 months.

  • Known or suspected intolerance or contraindication to beta-blockers including:

    • Known allergy to beta-blockers
    • History of moderate to severe bronchospastic lung disease (including moderate to severe asthma).
  • Severe pulmonary disease (chronic obstructive pulmonary disease).
  • Presence of any other history or condition that the investigator feels would be problematic.
  • SPECT preformed in non-validated center within 60 days prior to screening.
  • SPECT performed within the previous 6 months of screening but > 60 days.
  • SPECT studies performed within 60 days of screening that include rest and stress studies performed using 2 day protocols.
  • BMI greater than 40

Sites / Locations

  • Johns Hopkins School of Medicine
  • National Heart Lung and Blood Institute (NHLBI)
  • Beth Israel Deaconess Medical Center
  • Brigham and Women Hospital
  • Albert Einstein Hospital
  • INCOR Heart Institute University-Sao Paulo
  • Toronto General Hospital
  • Rigshospitalet - University of Copenhagen
  • Charite Humboldt University
  • Iwate Medical University
  • Keio University
  • St. Luke's International Hospital
  • Mie University
  • Leiden University
  • Mount Elizabeth Hospital
  • National Heart Center

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

Combined CT Angiography and Myocardial Perfusion

Arm Description

Single Arm study. All patients underwent combined CT Angiography and Myocardial Perfusion.

Outcomes

Primary Outcome Measures

Diagnostic accuracy of volume (multi-detector) computed tomography using 320 detectors in a patient with suspected coronary artery disease.
Diagnostic accuracy of volume (multi-detector) computed tomography using 320 detectors for identifying coronary artery luminal stenosis and corresponding myocardium perfusion defects in a patient with suspected coronary artery disease.

Secondary Outcome Measures

Diagnostic accuracy of volume computed tomography using 320 detectors in a vessel of a patient with suspected coronary artery disease.
Diagnostic accuracy of volume computed tomography using 320 detectors for identifying coronary artery luminal stenosis and corresponding territorial myocardium perfusion defects in a vessel of a patient with suspected coronary artery disease.
Compare the relative diagnostic accuracy of 320 CT angiography vs SPECT in predicting at least one ≥ 50% coronary stenosis detected by QCA
Compare the relative diagnostic accuracy of 320 CT angiography vs SPECT in predicting at least one ≥ 50% coronary stenosis detected by QCA
Compare the relative diagnostic accuracy of 320 CT perfusion vs SPECT in predicting at least one ≥ 50% coronary stenosis detected by quantitative conventional angiography.
Compare the relative diagnostic accuracy of 320 CT perfusion vs SPECT in predicting at least one ≥ 50% coronary stenosis detected by quantitative conventional angiography.

Full Information

First Posted
May 11, 2009
Last Updated
August 31, 2018
Sponsor
Johns Hopkins University
Collaborators
Toshiba America Medical Systems, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00934037
Brief Title
Combined Non-invasive Coronary Angiography and Myocardial Perfusion Imaging Using 320 Detector Computed Tomography
Acronym
Core320
Official Title
Multi Center Combined Non-invasive Coronary Angiography and Myocardial Perfusion Imaging Using 320-Detector Computed Tomography
Study Type
Interventional

2. Study Status

Record Verification Date
August 2018
Overall Recruitment Status
Completed
Study Start Date
December 2009 (Actual)
Primary Completion Date
September 2011 (Actual)
Study Completion Date
September 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Johns Hopkins University
Collaborators
Toshiba America Medical Systems, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to evaluate the diagnostic accuracy of multi-detector computed tomography using 320 detectors for identifying the combination of coronary artery stenosis ≥ 50% and a corresponding myocardium perfusion defect in a patient with suspected coronary artery disease compared with conventional coronary angiography and single photon emission computed tomography myocardium perfusion imaging.
Detailed Description
The Combined Coronary angiography and myocardial perfusion imaging using 320 detectors computed tomography (CORE-320) was designed as a prospective, multi-center, international, blinded study designed to evaluate the diagnostic accuracy of multi-detector computed tomography using 320 detectors for identifying coronary artery luminal stenosis and corresponding myocardium perfusion defects in patients with suspected coronary artery disease. The primary analysis will be a comparison of the diagnostic capability of the combination of quantitative 320-MDCT angiography and quantitative perfusion imaging to the combination of conventional coronary angiography and SPECT myocardial perfusion imaging at the patient level. A positive patient will be defined as having at least one vessel with a ≥ 50% diameter stenosis defined by quantitative coronary angiography and a corresponding positive SPECT territorial myocardial perfusion defect.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Arterial Occlusive Diseases, Coronary Disease, Heart Diseases, Myocardial Ischemia, Vascular Diseases, Arteriosclerosis, Ischemia, Coronary Artery Disease
Keywords
Coronary Artery Disease, Computed Tomography, Myoperfusion, Angiography, SPECT

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
N/A
Enrollment
444 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Combined CT Angiography and Myocardial Perfusion
Arm Type
Other
Arm Description
Single Arm study. All patients underwent combined CT Angiography and Myocardial Perfusion.
Intervention Type
Procedure
Intervention Name(s)
320 Volume Detector Computed Tomography
Intervention Description
Single Arm Study. All patients undergo Volume (Multidetector) CT.
Intervention Type
Other
Intervention Name(s)
Other: Multidetector Computed Tomography - 320 detectors
Other Intervention Name(s)
Aquilion ONE CT scanner
Intervention Description
Multidetector computed tomography angiography
Primary Outcome Measure Information:
Title
Diagnostic accuracy of volume (multi-detector) computed tomography using 320 detectors in a patient with suspected coronary artery disease.
Description
Diagnostic accuracy of volume (multi-detector) computed tomography using 320 detectors for identifying coronary artery luminal stenosis and corresponding myocardium perfusion defects in a patient with suspected coronary artery disease.
Time Frame
30-60 Days
Secondary Outcome Measure Information:
Title
Diagnostic accuracy of volume computed tomography using 320 detectors in a vessel of a patient with suspected coronary artery disease.
Description
Diagnostic accuracy of volume computed tomography using 320 detectors for identifying coronary artery luminal stenosis and corresponding territorial myocardium perfusion defects in a vessel of a patient with suspected coronary artery disease.
Time Frame
30-60 Days
Title
Compare the relative diagnostic accuracy of 320 CT angiography vs SPECT in predicting at least one ≥ 50% coronary stenosis detected by QCA
Description
Compare the relative diagnostic accuracy of 320 CT angiography vs SPECT in predicting at least one ≥ 50% coronary stenosis detected by QCA
Time Frame
30-60 Days
Title
Compare the relative diagnostic accuracy of 320 CT perfusion vs SPECT in predicting at least one ≥ 50% coronary stenosis detected by quantitative conventional angiography.
Description
Compare the relative diagnostic accuracy of 320 CT perfusion vs SPECT in predicting at least one ≥ 50% coronary stenosis detected by quantitative conventional angiography.
Time Frame
30-60 Days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
45 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patients, age 45-85. Women of child bearing potential must demonstrate a negative pregnancy test within 24 hours of the study MDCT. Suspected or diagnosed coronary artery disease with a clinical indication for coronary angiography; and planned coronary angiography within the next 60 days. Able to understand and willing to sign the Informed Consent Form. Exclusion Criteria: Known allergy to iodinated contrast media. History of contrast-induced nephropathy. History of multiple myeloma or previous organ transplantation. Elevated serum creatinine (> 1.5 mg/dl) OR calculated creatinine clearance of < 60 ml/min (using the Cockcroft-Gault formula. Atrial fibrillation or uncontrolled tachyarrhythmia, or advanced atrioventricular block (second or third degree heart block). Evidence of severe symptomatic heart failure (NYHA Class III or IV); Known or suspected moderate or severe aortic stenosis. Previous coronary artery bypass or other cardiac surgery. Coronary artery intervention within the last 6 months. Known or suspected intolerance or contraindication to beta-blockers including: Known allergy to beta-blockers History of moderate to severe bronchospastic lung disease (including moderate to severe asthma). Severe pulmonary disease (chronic obstructive pulmonary disease). Presence of any other history or condition that the investigator feels would be problematic. SPECT preformed in non-validated center within 60 days prior to screening. SPECT performed within the previous 6 months of screening but > 60 days. SPECT studies performed within 60 days of screening that include rest and stress studies performed using 2 day protocols. BMI greater than 40
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joao AC Lima, MD MBA
Organizational Affiliation
Johns Hopkins School of Medicine
Official's Role
Study Chair
Facility Information:
Facility Name
Johns Hopkins School of Medicine
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21205
Country
United States
Facility Name
National Heart Lung and Blood Institute (NHLBI)
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892
Country
United States
Facility Name
Beth Israel Deaconess Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Brigham and Women Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Albert Einstein Hospital
City
Sao Paulo
Country
Brazil
Facility Name
INCOR Heart Institute University-Sao Paulo
City
Sao Paulo
Country
Brazil
Facility Name
Toronto General Hospital
City
Toronto
Country
Canada
Facility Name
Rigshospitalet - University of Copenhagen
City
Blegdamsvej
ZIP/Postal Code
9, 2100
Country
Denmark
Facility Name
Charite Humboldt University
City
Berlin
Country
Germany
Facility Name
Iwate Medical University
City
Morioka
Country
Japan
Facility Name
Keio University
City
Tokyo
Country
Japan
Facility Name
St. Luke's International Hospital
City
Tokyo
Country
Japan
Facility Name
Mie University
City
TSU
Country
Japan
Facility Name
Leiden University
City
Leiden
Country
Netherlands
Facility Name
Mount Elizabeth Hospital
City
Singapore
Country
Singapore
Facility Name
National Heart Center
City
Singapore
Country
Singapore

12. IPD Sharing Statement

Citations:
PubMed Identifier
19038879
Citation
Miller JM, Rochitte CE, Dewey M, Arbab-Zadeh A, Niinuma H, Gottlieb I, Paul N, Clouse ME, Shapiro EP, Hoe J, Lardo AC, Bush DE, de Roos A, Cox C, Brinker J, Lima JA. Diagnostic performance of coronary angiography by 64-row CT. N Engl J Med. 2008 Nov 27;359(22):2324-36. doi: 10.1056/NEJMoa0806576.
Results Reference
background
PubMed Identifier
22146496
Citation
Vavere AL, Simon GG, George RT, Rochitte CE, Arai AE, Miller JM, Di Carli M, Arbab-Zadeh A, Dewey M, Niinuma H, Laham R, Rybicki FJ, Schuijf JD, Paul N, Hoe J, Kuribyashi S, Sakuma H, Nomura C, Yaw TS, Kofoed KF, Yoshioka K, Clouse ME, Brinker J, Cox C, Lima JA. Diagnostic performance of combined noninvasive coronary angiography and myocardial perfusion imaging using 320 row detector computed tomography: design and implementation of the CORE320 multicenter, multinational diagnostic study. J Cardiovasc Comput Tomogr. 2011 Nov-Dec;5(6):370-81. doi: 10.1016/j.jcct.2011.11.001. Epub 2011 Nov 12. Erratum In: J Cardiovasc Comput Tomogr. 2012 Mar-Apr;6(2):146. Zadeh, Armin A [corrected to Arbab-Zadeh, Armin].
Results Reference
background
PubMed Identifier
18998142
Citation
Miller JM, Dewey M, Vavere AL, Rochitte CE, Niinuma H, Arbab-Zadeh A, Paul N, Hoe J, de Roos A, Yoshioka K, Lemos PA, Bush DE, Lardo AC, Texter J, Brinker J, Cox C, Clouse ME, Lima JA. Coronary CT angiography using 64 detector rows: methods and design of the multi-centre trial CORE-64. Eur Radiol. 2009 Apr;19(4):816-28. doi: 10.1007/s00330-008-1203-7. Epub 2008 Nov 8.
Results Reference
background
PubMed Identifier
23185678
Citation
Yoneyama K, Vavere AL, Cerci R, Ahmed R, Arai AE, Niinuma H, Rybicki FJ, Rochitte CE, Clouse ME, George RT, Lima JA, Arbab-Zadeh A. Influence of image acquisition settings on radiation dose and image quality in coronary angiography by 320-detector volume computed tomography: the CORE320 pilot experience. Heart Int. 2012 Jun 5;7(2):e11. doi: 10.4081/hi.2012.e11. Epub 2012 Jun 25.
Results Reference
background
PubMed Identifier
22887690
Citation
Cerci RJ, Arbab-Zadeh A, George RT, Miller JM, Vavere AL, Mehra V, Yoneyama K, Texter J, Foster C, Guo W, Cox C, Brinker J, Di Carli M, Lima JA. Aligning coronary anatomy and myocardial perfusion territories: an algorithm for the CORE320 multicenter study. Circ Cardiovasc Imaging. 2012 Sep 1;5(5):587-95. doi: 10.1161/CIRCIMAGING.111.970608. Epub 2012 Aug 10.
Results Reference
background
PubMed Identifier
22447807
Citation
George RT, Arbab-Zadeh A, Miller JM, Vavere AL, Bengel FM, Lardo AC, Lima JA. Computed tomography myocardial perfusion imaging with 320-row detector computed tomography accurately detects myocardial ischemia in patients with obstructive coronary artery disease. Circ Cardiovasc Imaging. 2012 May 1;5(3):333-40. doi: 10.1161/CIRCIMAGING.111.969303. Epub 2012 Mar 23.
Results Reference
background
PubMed Identifier
21940569
Citation
George RT, Arbab-Zadeh A, Cerci RJ, Vavere AL, Kitagawa K, Dewey M, Rochitte CE, Arai AE, Paul N, Rybicki FJ, Lardo AC, Clouse ME, Lima JA. Diagnostic performance of combined noninvasive coronary angiography and myocardial perfusion imaging using 320-MDCT: the CT angiography and perfusion methods of the CORE320 multicenter multinational diagnostic study. AJR Am J Roentgenol. 2011 Oct;197(4):829-37. doi: 10.2214/AJR.10.5689.
Results Reference
background
PubMed Identifier
22146495
Citation
Mehra VC, Valdiviezo C, Arbab-Zadeh A, Ko BS, Seneviratne SK, Cerci R, Lima JA, George RT. A stepwise approach to the visual interpretation of CT-based myocardial perfusion. J Cardiovasc Comput Tomogr. 2011 Nov-Dec;5(6):357-69. doi: 10.1016/j.jcct.2011.10.010. Epub 2011 Oct 31.
Results Reference
background
PubMed Identifier
35099638
Citation
Preuss D, Garcia G, Laule M, Dewey M, Rief M. Myocardial CT perfusion imaging for the detection of obstructive coronary artery disease: multisegment reconstruction does not improve diagnostic performance. Eur Radiol Exp. 2022 Jan 31;6(1):5. doi: 10.1186/s41747-021-00256-8.
Results Reference
derived
PubMed Identifier
34024757
Citation
Dewey M, Rochitte CE, Ostovaneh MR, Chen MY, George RT, Niinuma H, Kitagawa K, Laham R, Kofoed K, Nomura C, Sakuma H, Yoshioka K, Mehra VC, Jinzaki M, Kuribayashi S, Laule M, Paul N, Scholte AJ, Cerci R, Hoe J, Tan SY, Rybicki FJ, Matheson MB, Vavere AL, Arai AE, Miller JM, Cox C, Brinker J, Clouse ME, Di Carli M, Lima JAC, Arbab-Zadeh A. Prognostic value of noninvasive combined anatomic/functional assessment by cardiac CT in patients with suspected coronary artery disease - Comparison with invasive coronary angiography and nuclear myocardial perfusion imaging for the five-year-follow up of the CORE320 multicenter study. J Cardiovasc Comput Tomogr. 2021 Nov-Dec;15(6):485-491. doi: 10.1016/j.jcct.2021.04.005. Epub 2021 May 12.
Results Reference
derived
PubMed Identifier
32361925
Citation
Kishi S, Magalhaes TA, Cerci RJ, Zimmermann E, Matheson MB, Vavere A, Tanami Y, Kitslaar PH, George RT, Brinker J, Miller JM, Clouse ME, Lemos PA, Niinuma H, Reiber JHC, Kofoed KF, Rochitte CE, Rybicki FJ, Di Carli MF, Cox C, Lima JAC, Arbab-Zadeh A. Comparative effectiveness of coronary artery stenosis and atherosclerotic plaque burden assessment for predicting 30-day revascularization and 2-year major adverse cardiac events. Int J Cardiovasc Imaging. 2020 Dec;36(12):2365-2375. doi: 10.1007/s10554-020-01851-3. Epub 2020 May 2.
Results Reference
derived
PubMed Identifier
31746688
Citation
Schuijf JD, Matheson MB, Ostovaneh MR, Arbab-Zadeh A, Kofoed KF, Scholte AJHA, Dewey M, Steveson C, Rochitte CE, Yoshioka K, Cox C, Di Carli MF, Lima JAC. Ischemia and No Obstructive Stenosis (INOCA) at CT Angiography, CT Myocardial Perfusion, Invasive Coronary Angiography, and SPECT: The CORE320 Study. Radiology. 2020 Jan;294(1):61-73. doi: 10.1148/radiol.2019190978. Epub 2019 Nov 19.
Results Reference
derived
PubMed Identifier
30764641
Citation
Song YB, Arbab-Zadeh A, Matheson MB, Ostovaneh MR, Vavere AL, Dewey M, Rochitte C, Niinuma H, Laham R, Schuijf JD, Cox C, Brinker J, di Carli M, Lima JAC, Miller JM. Contemporary Discrepancies of Stenosis Assessment by Computed Tomography and Invasive Coronary Angiography. Circ Cardiovasc Imaging. 2019 Feb;12(2):e007720. doi: 10.1161/CIRCIMAGING.118.007720.
Results Reference
derived
PubMed Identifier
28956734
Citation
Rief M, Chen MY, Vavere AL, Kendziora B, Miller JM, Bandettini WP, Cox C, George RT, Lima J, Di Carli M, Plotkin M, Zimmermann E, Laule M, Schlattmann P, Arai AE, Dewey M. Coronary Artery Disease: Analysis of Diagnostic Performance of CT Perfusion and MR Perfusion Imaging in Comparison with Quantitative Coronary Angiography and SPECT-Multicenter Prospective Trial. Radiology. 2018 Feb;286(2):461-470. doi: 10.1148/radiol.2017162447. Epub 2017 Sep 25.
Results Reference
derived
PubMed Identifier
27811151
Citation
Penagaluri A, Higgins AY, Vavere AL, Miller JM, Arbab-Zadeh A, Betoko A, Steveson C, Zimmermann E, Cox C, Rochitte CE, Dewey M, Kofoed KF, Niinuma H, Di Carli MF, Lima JA, Chen MY. Computed Tomographic Perfusion Improves Diagnostic Power of Coronary Computed Tomographic Angiography in Women: Analysis of the CORE320 Trial (Coronary Artery Evaluation Using 320-Row Multidetector Computed Tomography Angiography and Myocardial Perfusion) According to Gender. Circ Cardiovasc Imaging. 2016 Nov;9(11):e005189. doi: 10.1161/CIRCIMAGING.116.005189.
Results Reference
derived
PubMed Identifier
26467105
Citation
Arbab-Zadeh A, Di Carli MF, Cerci R, George RT, Chen MY, Dewey M, Niinuma H, Vavere AL, Betoko A, Plotkin M, Cox C, Clouse ME, Arai AE, Rochitte CE, Lima JA, Brinker J, Miller JM. Accuracy of Computed Tomographic Angiography and Single-Photon Emission Computed Tomography-Acquired Myocardial Perfusion Imaging for the Diagnosis of Coronary Artery Disease. Circ Cardiovasc Imaging. 2015 Oct;8(10):e003533. doi: 10.1161/CIRCIMAGING.115.003533.
Results Reference
derived
PubMed Identifier
26334382
Citation
Sharma RK, Arbab-Zadeh A, Kishi S, Chen MY, Magalhaes TA, George RT, Dewey M, Rybicki FJ, Kofoed KF, de Roos A, Tan SY, Matheson M, Vavere A, Cox C, Clouse ME, Miller JM, Brinker JA, Arai AE, Di Carli MF, Rochitte CE, Lima JA. 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. 2015 Dec 15;201:570-7. doi: 10.1016/j.ijcard.2015.05.110. Epub 2015 May 19.
Results Reference
derived
PubMed Identifier
25977111
Citation
Magalhaes TA, Kishi S, George RT, Arbab-Zadeh A, Vavere AL, Cox C, Matheson MB, Miller JM, Brinker J, Di Carli M, Rybicki FJ, Rochitte CE, Clouse ME, Lima JA. Combined coronary angiography and myocardial perfusion by computed tomography in the identification of flow-limiting stenosis - The CORE320 study: An integrated analysis of CT coronary angiography and myocardial perfusion. J Cardiovasc Comput Tomogr. 2015 Sep-Oct;9(5):438-45. doi: 10.1016/j.jcct.2015.03.004. Epub 2015 Mar 21.
Results Reference
derived
PubMed Identifier
25539270
Citation
Rybicki FJ, Mather RT, Kumamaru KK, Brinker J, Chen MY, Cox C, Matheson MB, Dewey M, DiCarli MF, Miller JM, Geleijns J, George RT, Paul N, Texter J, Vavere A, Yaw TS, Lima JA, Clouse ME. Comprehensive assessment of radiation dose estimates for the CORE320 study. AJR Am J Roentgenol. 2015 Jan;204(1):W27-36. doi: 10.2214/AJR.13.12375.
Results Reference
derived

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Combined Non-invasive Coronary Angiography and Myocardial Perfusion Imaging Using 320 Detector Computed Tomography

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