Combining myocardial perfusion imaging with computed tomography for diagnosis of coronary artery disease.
OBJECTIVE
To illustrate where the integration of computed tomography with myocardial perfusion single photon tomography may improve current diagnostic imaging paradigms and allow for enhanced risk stratification.


RESULTS
Computed tomography has the advantage of detecting coronary atherosclerosis at its earliest stages and also identifying patients at high risk for having underlying myocardial ischemia, allowing initiation of appropriate therapeutic measures well before development of obstructive coronary artery disease. Single photon computed tomography can, conversely, clarify the anatomic findings of computed tomography, based on a functional assessment of myocardial blood flow, thereby guiding antiischemic and interventional therapies.


CONCLUSIONS
Hybrid imaging with single photon tomography and computed tomography angiography may prove important from a diagnostic and therapeutic viewpoint in several clinical scenarios. It is likely that fusion imaging may more precisely tailor therapy, reduce healthcare costs and improve patient outcome over the next decade.
Mahmarian
John J
JJ
Methodist DeBakey Heart Center, Department of Cardiology, The Methodist Hospital, Houston, Texas, USA. jmahmarian@tmhs.org
D000368:Aged; D002114:Calcinosis / Q000000981:diagnostic imaging*; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D018572:Disease-Free Survival; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D018570:Risk Assessment / Q000379:methods; D016019:Survival Analysis; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*