Diagnostic advantage of stress computed tomography myocardial perfusion over single-photon emission computed tomography for the assessment of myocardial ischemia

Abstract

CTP demonstrated a significant diagnostic advantage over SPECT in the identification of significant CAD, especially in terms of sensitivity and PPV. Adenosine stress CTP is useful for the noninvasive diagnosis of functionally significant CAD.

Prognosis of anatomic coronary artery disease without myocardial ischemia: Coronary computed tomography angiography detects high-risk patients even in cases of negative single-photon emission computed tomography findings

“…The extent, distribution, and composition of atherosclerotic plaques, as well as the anatomical significance of CAD (generally defined as DS of !50%) evaluated by CCTA have prognostic implications [1,2,4,[8][9][10][14][15][16][17][18]30]. Accordingly, CCTA has provoked a paradigm shift from the identification of functionally significant stenosis alone to image-based identification of patient risk [31]. However, to date, most clinicians have focused on the presence of functionally significant CAD that results in myocardial ischemia requiring revascularization [5,6].…”

CAD-RADS™ 2.0 – 2022 Coronary Artery Disease – Reporting and Data System An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Cardiology (ACC), the American College of Radiology (ACR) and the North America Society of Cardiovascular Imaging (NASCI)

“…technology, in particular the development of wide-area detectors with greater z-axis coverage and dual-source CT, have improved functional assessment of the myocardium using stress CTP. Myocardial CTP has been validated in patients with acute and chronic chest pain against modalities such as cardiac MRI, SPECT-MPI, invasive coronary angiography, invasive FFR and cardiac biomarkers (53)(54)(55). Furthermore, a combined approach of myocardial CTP with coronary CTA has been shown to have better diagnostic accuracy than CCTA alone in patients at intermediate-to-high risk for coronary artery disease (CAD) (56)(57)(58).…”

CAD-RADS™ 2.0 - 2022 Coronary Artery Disease-Reporting and Data System

“…Myocardial CTP has been validated in patients with acute and chronic chest pain against modalities such as cardiac MRI, SPECT-MPI, invasive coronary angiography, invasive FFR and cardiac biomarkers. [53][54][55] Furthermore, a combined approach of myocardial CTP with coronary CTA has been shown to have better diagnostic accuracy than CCTA alone in patients at intermediate-to-high risk for coronary artery disease (CAD). [56][57][58] Therefore, the Society of Cardiovascular Computed Tomography has provided resources to facilitate clinical implementation of CTP.…”