 Over the last 10 years, our group and others around the world have developed a method of imaging myocardial perfusion by CT CTP. This test is an adjunct to the usual Cardiac Computed Tomography Angiography CCTA procedure and can be done immediately thereafter, using conventional pharmacologic stress agents. It has demonstrated accuracy in many single center trials, and in our large multicenter study, the CORE320 trial 9,10 which showed a high accuracy in predicting the combined results of QCA plus MPI testing and a second multicenter trial established non-inferiority of myocardial CTP compared with nuclear stress testing 11,12. Additionally, our group has published a direct comparison of diagnostic performance of myocardial CTP imaging and SPECT myocardial perfusion imaging and demonstrated superior diagnostic performance of CTP imaging compared with SPECT for the diagnosis of significant disease on invasive angiography 13. 