Value of Dynamic Computed Tomography Myocardial Perfusion in CAD: A Systematic Review and Meta-analysis.

AIMS: Dynamic stress computed tomography (CT) perfusion is a non-invasive method for quantifying myocardial ischemia by assessing myocardial blood flow (MBF). In this meta-analysis, we evaluated the diagnostic accuracy of dynamic CT perfusion for the detection of significant coronary artery disease (CAD) across various CT scanners, obese patients, and its prognostic value. METHODS AND RESULTS: We systematically searched PubMed, Embase, Web of Science, and Cochrane library for published studies evaluating the accuracy of CT myocardial perfusion in diagnosing functional significant ischemia by invasive fractional flow reserve. The diagnostic performance of dynamic CT perfusion in detecting ischemia was evaluated using a summary receiver operating characteristic (sROC) curve. A total of 23 studies underwent meta- analysis. In myocardial region without ischemia, MBF was measured at 1.44 ml/min/g (95% confidence interval [CI]: 1.13-1.75), while in region with ischemia, it was 0.94 ml/min/g (95% CI: 0.80-1.08) (p<0.001). On the patient-based analysis, the area under the sROC curve of CT-MBF was 0.93, with a sensitivity of 0.84 and specificity of 0.88. Differences in CT type (dual source vs. single source), and body mass index (BMI) did not significantly affect the diagnostic performance. The pooled hazard ratio of dynamic CT perfusion for predicting adverse events was 4.98 (95%CI: 2.08-11.93, p=<0.001, I2=61%, p for heterogeneity = 0.07). CONCLUSIONS: Dynamic CT perfusion has high diagnostic performance in the quantitative assessment of ischemia and detection of functional myocardial ischemia as defined by invasive FFR, and may be useful in risk stratification of CAD patients.

Pseudo-spin switches and Aharonov-Bohm effect for topological boundary modes.

Topological boundary modes in electronic and classical-wave systems exhibit fascinating properties. In photonics, topological nature of boundary modes can make them robust and endows them with an additional internal structure-pseudo-spins. Here, we introduce heterogeneous boundary modes, which are based on mixing two of the most widely used topological photonics platforms-the pseudo-spin-Hall-like and valley-Hall photonic topological insulators. We predict and confirm experimentally that transformation between the two, realized by altering the lattice geometry, enables a continuum of boundary states carrying both pseudo-spin and valley degrees of freedom (DoFs). When applied adiabatically, this leads to conversion between pseudo-spin and valley polarization. We show that such evolution gives rise to a geometrical phase associated with the synthetic gauge fields, which is confirmed via an Aharonov-Bohm type experiment on a silicon chip. Our results unveil a versatile approach to manipulating properties of topological photonic states and envision topological photonics as a powerful platform for devices based on synthetic DoFs.

Spin-dependent properties of optical modes guided by adiabatic trapping potentials in photonic Dirac metasurfaces.

The Dirac-like dispersion in photonic systems makes it possible to mimic the dispersion of relativistic spin-1/2 particles, which led to the development of the concept of photonic topological insulators. Despite recent demonstrations of various topological photonic phases, the full potential offered by Dirac photonic systems, specifically their ability to emulate the spin degree of freedom-referred to as pseudo-spin-beyond topological boundary modes has remained underexplored. Here we demonstrate that photonic Dirac metasurfaces with smooth one-dimensional trapping gauge potentials serve as effective waveguides with modes carrying pseudo-spin. We show that spatially varying gauge potentials act unevenly on the two pseudo-spins due to their different field distributions, which enables control of guided modes by their spin, a property that is unattainable with conventional optical waveguides. Silicon nanophotonic metasurfaces are used to experimentally confirm the properties of these guided modes and reveal their distinct spin-dependent radiative character; modes of opposite pseudo-spin exhibit disparate radiative lifetimes and couple differently to incident light. The spin-dependent field distributions and radiative lifetimes of their guided modes indicate that photonic Dirac metasurfaces could be used for spin-multiplexing, controlling the characteristics of optical guided modes, and tuning light-matter interactions with photonic pseudo-spins.

All-optical nonreciprocity due to valley polarization pumping in transition metal dichalcogenides.

Nonreciprocity and nonreciprocal optical devices play a vital role in modern photonic technologies by enforcing one-way propagation of light. Here, we demonstrate an all-optical approach to nonreciprocity based on valley-selective response in transition metal dichalcogenides (TMDs). This approach overcomes the limitations of magnetic materials and it does not require an external magnetic field. We provide experimental evidence of photoinduced nonreciprocity in a monolayer WS2 pumped by circularly polarized (CP) light. Nonreciprocity stems from valley-selective exciton population, giving rise to nonlinear circular dichroism controlled by CP pump fields. Our experimental results reveal a significant effect even at room temperature, despite considerable intervalley-scattering, showing promising potential for practical applications in magnetic-free nonreciprocal platforms. As an example, here we propose a device scheme to realize an optical isolator based on a pass-through silicon nitride (SiN) ring resonator integrating the optically biased TMD monolayer.

Giant enhancement of Faraday rotation due to electromagnetically induced transparency in all-dielectric magneto-optical metasurfaces.

In this Letter we introduce a new class of Fano-resonant all-dielectric metasurfaces for enhanced, high figure of merit magneto-optical response. The metasurfaces are formed by an array of magneto-optical bismuth-substituted yttrium iron garnet nano-disks embedded into a low-index matrix. The strong field enhancement in the magneto-optical disks, which results in over an order of magnitude enhancement of Faraday rotation, is achieved by engineering two (electric and magnetic) resonances. It is shown that while enhancement of rotation also takes place for spectrally detuned resonances, the resonant excitation inevitably results in stronger reflection and low figure of merit of the device. We demonstrate that this can be circumvented by overlapping electric and magnetic resonances of the nanodisks, yielding a sharp electromagnetically induced transparency peak in the transmission spectrum, which is accompanied by gigantic Faraday rotation. Our results show that one can simultaneously obtain a large Faraday rotation enhancement along with almost 100% transmittance in an all-dielectric metasurface as thin as 300 nm. A simple analytical model based on coupled-mode theory is introduced to explain the effects observed in first-principle finite element method simulations.