Computed tomography myocardial perfusion

ESC CardioMed ◽  
2018 ◽  
pp. 556-560
Author(s):  
Amita Singh ◽  
Noreen Nazir ◽  
Victor Mor-Avi ◽  
Amit R. Patel
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Single Photon ◽  
Photon Emission ◽  
High Negative Predictive Value ◽  
Artery Disease

Coronary computed tomography angiography (CTA) has been widely adopted as a non-invasive tool for the evaluation of coronary artery disease. Given its high negative predictive value, it is an accurate modality to rule out obstructive coronary artery disease in the setting of chest pain. While the sensitivity and derived negative predictive value of coronary CTA are excellent, the specificity and positive predictive value are lower due to the difficult image interpretation in the presence of heavy coronary calcification, stents, coronary bypass grafts, motion artefacts, and arrhythmias. Vasodilator computed tomography myocardial perfusion (CTP) is an emerging technique with the ability to identify myocardial segments perfused by haemodynamically significant coronary stenoses. A growing number of studies have demonstrated the feasibility and diagnostic accuracy of CTP in comparison to a number of reference standards, including single-photon emission computed tomography, cardiovascular magnetic resonance imaging, and invasive coronary angiography with and without fractional flow reserve testing. This chapter summarizes the current state of CTP.

Assessment of coronary artery disease: imaging-guided management and therapy

ESC CardioMed ◽  
2018 ◽  
pp. 585-589
Author(s):  
Juhani Knuuti ◽  
S. Richard Underwood ◽  
Antti Saraste
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Single Photon ◽  
Photon Emission ◽  
Cost Effective ◽  
Absolute Quantification ◽  
Diagnosis And Prognosis ◽  
Positron Emission ◽  
Artery Disease

Single-photon emission computed tomography (SPECT) and positron emission tomography (PET) myocardial perfusion scintigraphy (MPS) have been validated for the diagnosis and prognosis of cardiac disease and the techniques. MPS is safe and cost-effective in a wide variety of clinical settings. The evidence for the SPECT MPS technique is broad and supports its use. Although less widely available, PET is a very accurate technique in detecting myocardial ischaemia. It allows absolute quantification of myocardial perfusion that will provide additional guidance for the therapy of coronary artery disease.

Nuclear cardiology and detection of coronary artery disease

2021 ◽  
pp. 403-419
Author(s):  
Richard Underwood ◽  
James Stirrup ◽  
Danilo Neglia
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Nuclear Cardiology ◽  
Single Photon ◽  
Photon Emission ◽  
Diagnosis And Prognosis ◽  
Positron Emission ◽  
Artery Disease ◽  
Stable Cad

Experience with radionuclide assessments of myocardial perfusion can be measured over decades. Myocardial perfusion scintigraphy (MPS), performed by either single-photon emission computed tomography (SPECT) or positron emission tomography (PET), has been validated for the diagnosis and prognosis of coronary artery disease (CAD) and is embedded in national and international guidelines. With multiple alternative cardiac imaging modalities available, it is important to understand the principles, indications, and pitfalls of each option. No single technique provides a complete assessment of the heart; many provide complementary rather than equivalent information. In this chapter, the value of cardiac radionuclide imaging in stable CAD and acute coronary syndromes (ACS) is discussed, with a particular emphasis on the role of SPECT MPS, the most commonly used technique in nuclear cardiology.

Assessment of coronary artery disease: chronic stable angina

ESC CardioMed ◽  
2018 ◽  
pp. 582-585
Author(s):  
Juhani Knuuti ◽  
S. Richard Underwood ◽  
Antti Saraste
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Single Photon ◽  
Obstructive Coronary Artery Disease ◽  
Photon Emission ◽  
Chronic Stable Angina ◽  
Imaging Test ◽  
Artery Disease ◽  
Stable Cad

Single-photon emission computed tomography and positron emission tomography myocardial perfusion scintigraphy (MPS) have been validated for the diagnosis of obstructive coronary artery disease (CAD) and assessment of prognosis in this condition. The techniques are also included in national and international guidelines. The choice of cardiac imaging test is determined by the clinical scenario and also local expertise. MPS is a functional imaging test that can detect abnormal myocardial perfusion associated with myocardial ischaemia. As impairment of myocardial perfusion precedes both ischaemic wall motion and electrocardiographic abnormalities, MPS is a sensitive technique for detecting CAD. In this chapter, the value of MPS in stable CAD is discussed.

scholarly journals The role of myocardial scintigraphy in the assessment of coronary artery disease

2016 ◽  
Vol 68 (4) ◽  
Author(s):  
Pasquale Perrone Filardi ◽  
Alberto Cuocolo ◽  
Andrea Petretta ◽  
Gianluca Caiazzo ◽  
Pierluigi Costanzo ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Single Photon ◽  
Systolic Function ◽  
Photon Emission ◽  
Left Ventricular ◽  
Emission Computed Tomography ◽  
Myocardial Spect ◽  
Artery Disease

Single photon emission computed tomography (SPECT) for the assessment of myocardial perfusion was introduced in the early 1970s, following pioneer studies of Gould et al. It has rapidly become one of the most used noninvasive technique for the assessment of myocardial ischemia. Thanks to the current technetium based tracers that allow electrocardiogram gated synchronization, it is possible to assess the regional ventricular systolic function and the evaluation of myocardial perfusion as well. In the last twenty years, beyond its diagnostic role, myocardial SPECT has become also a prognostic technique. Indeed, it has acquired a role for the short-term prediction of major coronary events in a large cohort with known or suspected coronary artery disease (CAD). The aim of this review is to give an update of the correct use and interpretation of myocardial SPECT in patients with known or suspected CAD and without left ventricular dysfunction.

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