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Complementary Roles of Coronary CT and Myocardial Perfusion SPECT

  • Chapter
Multislice CT

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

Appropriate diagnosis and therapy of CAD frequently requires information about both the morphological and functional status of the coronary artery tree. Thus, combined imaging consisting of invasive coronary angiography (ICA) and myocardial perfusion imaging (MPI) has been practiced in clinical routine diagnostics of patients with stable angina for many years, and can therefore be accepted as the reference standard in the diagnosis of hemodynamically relevant coronary artery stenoses. Both morphological and functional information are mandatory for the decision of performing an interventional therapy or initiating/maintaining medical treatment in numerous symptomatic patients. The hemodynamic relevance of coronary artery lesions is a major condition in deciding whether an interventional therapy should be performed. A noninvasive concept providing both morphological and functional information could provide accurate allocation of perfusion defects to their determining coronary lesion, and specific morphological and functional classification of patients with CAD. Complementary effects were observed for the combination of CTA and MPI in patients with suspected or known CAD, particularly when 3D image fusion was performed. Additionally, in the setting of patient screening, CT calcium scoring is accepted for exclusion of present CAD. Otherwise, in cases of coronary calcium burden >400, the probability of present ischemia increases to 25%, so that these patients require further functional diagnostic-like MPI.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Marchioninistrasse 15, 81377, Munich, Germany

    Marcus Hacker

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  1. Marcus Hacker
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Editors and Affiliations

  1. Munich University Hospital, Institute of Clinical Radiology, Ludwig-Maximilians University, Marchioninistr. 15, 81377, Munich, Germany

    Maximilian F. Reiser , C.R. Becker  & Konstantin Nikolaou ,  & 

  2. School of Medicine, Department of Radiology, Stanford University, 1201 Welch Road, 94304, Palo Alto, CA, USA

    Gary Glazer

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© 2009 Springer-Verlag Berlin Heidelberg

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Hacker, M. (2009). Complementary Roles of Coronary CT and Myocardial Perfusion SPECT. In: Reiser, M., Becker, C., Nikolaou, K., Glazer, G. (eds) Multislice CT. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-33125-4_22

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  • DOI: https://doi.org/10.1007/978-3-540-33125-4_22

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-33124-7

  • Online ISBN: 978-3-540-33125-4

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