title: Effective risk stratification of patients on the basis of myocardial perfusion SPECT is dependent on appropriate patient selection.
abstract: Myocardial perfusion imaging (MPI) with single-photon emission computed tomography (SPECT) is commonly used in risk assessment, as an abnormal scan predicts a multifold increase in cardiac risk. Recent studies have showed that application of the appropriate use criteria (AUC) sharpens the prognostic value of SPECT-MPI, while inappropriate use is clinically ineffective and may lead to unnecessary downstream invasive testing and revascularization procedures. In this review, we will discuss recent literature examining the impact of appropriate use on the prognostic value of SPECT-MPI and downstream decision-making. We will also discuss the implications of appropriate use on cost-effectiveness of MPI.
authors.affiliation: Division of Cardiology, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Alexander
authors.forename: Rami
authors.initials: R
authors.lastname: Doukky
mesh_terms: D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003362:Cost-Benefit Analysis; D003657:Decision Making; D006300:Health Services Misuse / Q000706:statistics & numerical data; D006801:Humans; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging*; D055414:Myocardial Perfusion Imaging / Q000706:statistics & numerical data; D018579:Patient Selection; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000706:statistics & numerical data; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000706:statistics & numerical data