Clinical quantitative cardiac imaging for the assessment of myocardial ischaemia
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Open Access
- 23 February 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Nature Reviews Cardiology
- Vol. 17 (7), 427-450
- https://doi.org/10.1038/s41569-020-0341-8
Abstract
Cardiac imaging has a pivotal role in the prevention, diagnosis and treatment of ischaemic heart disease. SPECT is most commonly used for clinical myocardial perfusion imaging, whereas PET is the clinical reference standard for the quantification of myocardial perfusion. MRI does not involve exposure to ionizing radiation, similar to echocardiography, which can be performed at the bedside. CT perfusion imaging is not frequently used but CT offers coronary angiography data, and invasive catheter-based methods can measure coronary flow and pressure. Technical improvements to the quantification of pathophysiological parameters of myocardial ischaemia can be achieved. Clinical consensus recommendations on the appropriateness of each technique were derived following a European quantitative cardiac imaging meeting and using a real-time Delphi process. SPECT using new detectors allows the quantification of myocardial blood flow and is now also suited to patients with a high BMI. PET is well suited to patients with multivessel disease to confirm or exclude balanced ischaemia. MRI allows the evaluation of patients with complex disease who would benefit from imaging of function and fibrosis in addition to perfusion. Echocardiography remains the preferred technique for assessing ischaemia in bedside situations, whereas CT has the greatest value for combined quantification of stenosis and characterization of atherosclerosis in relation to myocardial ischaemia. In patients with a high probability of needing invasive treatment, invasive coronary flow and pressure measurement is well suited to guide treatment decisions. In this Consensus Statement, we summarize the strengths and weaknesses as well as the future technological potential of each imaging modality.Keywords
This publication has 194 references indexed in Scilit:
- Diagnosing coronary artery disease with hybrid PET/CT: It takes two to tangoJournal of Nuclear Cardiology, 2013
- Parametric imaging of myocardial viability using 15O-labelled water and PET/CT: comparison with late gadolinium-enhanced CMREuropean Journal of Nuclear Medicine and Molecular Imaging, 2012
- Quantitative myocardial perfusion analysis using multi-row detector CT in acute myocardial infarctionHeart, 2012
- Superior diagnostic performance of perfusion-cardiovascular magnetic resonance versus SPECT to detect coronary artery disease: The secondary endpoints of the multicenter multivendor MR-IMPACT II (Magnetic Resonance Imaging for Myocardial Perfusion Assessment in Coronary Artery Disease Trial)Journal of Cardiovascular Magnetic Resonance, 2012
- Cardiovascular magnetic resonance and single-photon emission computed tomography for diagnosis of coronary heart disease (CE-MARC): a prospective trialThe Lancet, 2011
- Investigation of dynamic SPECT measurements of the arterial input function in human subjects using simulation, phantom and human studiesPhysics in Medicine & Biology, 2011
- Coronary pressure-flow relations as basis for the understanding of coronary physiologyJournal of Molecular and Cellular Cardiology, 2011
- Quantitative contrast-enhanced ultrasound imaging: a review of sources of variabilityInterface Focus, 2011
- A fast cardiac gamma camera with dynamic SPECT capabilities: design, system validation and future potentialEuropean Journal of Nuclear Medicine and Molecular Imaging, 2010
- Patient Acceptance of Noninvasive and Invasive Coronary AngiographyPLOS ONE, 2007