Comparative use of radionuclide stress testing, coronary artery calcium scanning, and noninvasive coronary angiography for diagnostic and prognostic cardiac assessment

Daniel S. Berman, Leslee J. Shaw, James K. Min, Aiden Abidov, Guido Germano, Sean W. Hayes, John D. Friedman, Louise E J Thomson, Xingping Kang, Piotr J. Slomka, Alan Rozanski

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Single-photon emission computed tomography (SPECT) or positron emission tomography (PET) myocardial perfusion scintigraphy (MPS) is a well-established noninvasive imaging modality that is a core element in evaluation of patients with stable chest pain syndromes. Stress SPECT MPS is the most commonly utilized stress imaging technique for patients with suspected or known coronary artery disease (CAD) and has a robust evidence base including the support of numerous clinical guidelines. By comparison, cardiac computed tomography (CT) is a more recently developed method, providing noninvasive approaches for imaging coronary atherosclerosis and coronary artery stenosis. After being in use for well over a decade, noncontrast CT for imaging the extent of coronary artery calcification (CAC) has an extensive evidence base supporting its use in CAD prevention. Contrast-enhanced CT for noninvasive CT coronary angiography (CCTA) is relatively new, but has a rapidly growing evidence base regarding diagnosing obstructive CAD and assessing risk. It is likely that noncontrast CT or CCTA for assessment of extent of atherosclerosis will become an increasing part of mainstream cardiovascular imaging practices as a first-line test. In some patients, further ischemia testing with MPS will be required. Similarly, MPS will continue to be widely used as a first-line test, and, in some patients, further anatomic definition of atherosclerosis with CT will also be appropriate. This review also provides a synopsis of the available literature on imaging that integrates both CT and MPS in strategies for the assessment of asymptomatic patients for their atherosclerotic coronary disease burden and risk as well as symptomatic patients for diagnosis and guiding management. We propose possible risk-based strategies through which imaging might be used to identify asymptomatic candidates for more intensive prevention and risk factor modification strategies as well as symptomatic patients who would benefit from referral to invasive coronary angiography (ICA) for consideration of revascularization.

Original languageEnglish (US)
Title of host publicationCardiac CT Imaging: Diagnosis of Cardiovascular Disease: Second Edition
PublisherSpringer London
Pages233-254
Number of pages22
ISBN (Print)9781848826496
DOIs
StatePublished - 2010

Fingerprint

Coronary Angiography
Radioisotopes
Myocardial Perfusion Imaging
Perfusion Imaging
Coronary Vessels
Calcium
Tomography
Coronary Artery Disease
Single-Photon Emission-Computed Tomography
Atherosclerosis
Coronary Stenosis
Chest Pain
Positron-Emission Tomography
Coronary Disease
Referral and Consultation
Ischemia
Guidelines

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Berman, D. S., Shaw, L. J., Min, J. K., Abidov, A., Germano, G., Hayes, S. W., ... Rozanski, A. (2010). Comparative use of radionuclide stress testing, coronary artery calcium scanning, and noninvasive coronary angiography for diagnostic and prognostic cardiac assessment. In Cardiac CT Imaging: Diagnosis of Cardiovascular Disease: Second Edition (pp. 233-254). Springer London. https://doi.org/10.1007/978-1-84882-650-2_19

Comparative use of radionuclide stress testing, coronary artery calcium scanning, and noninvasive coronary angiography for diagnostic and prognostic cardiac assessment. / Berman, Daniel S.; Shaw, Leslee J.; Min, James K.; Abidov, Aiden; Germano, Guido; Hayes, Sean W.; Friedman, John D.; Thomson, Louise E J; Kang, Xingping; Slomka, Piotr J.; Rozanski, Alan.

Cardiac CT Imaging: Diagnosis of Cardiovascular Disease: Second Edition. Springer London, 2010. p. 233-254.

Research output: Chapter in Book/Report/Conference proceedingChapter

Berman, DS, Shaw, LJ, Min, JK, Abidov, A, Germano, G, Hayes, SW, Friedman, JD, Thomson, LEJ, Kang, X, Slomka, PJ & Rozanski, A 2010, Comparative use of radionuclide stress testing, coronary artery calcium scanning, and noninvasive coronary angiography for diagnostic and prognostic cardiac assessment. in Cardiac CT Imaging: Diagnosis of Cardiovascular Disease: Second Edition. Springer London, pp. 233-254. https://doi.org/10.1007/978-1-84882-650-2_19
Berman DS, Shaw LJ, Min JK, Abidov A, Germano G, Hayes SW et al. Comparative use of radionuclide stress testing, coronary artery calcium scanning, and noninvasive coronary angiography for diagnostic and prognostic cardiac assessment. In Cardiac CT Imaging: Diagnosis of Cardiovascular Disease: Second Edition. Springer London. 2010. p. 233-254 https://doi.org/10.1007/978-1-84882-650-2_19
Berman, Daniel S. ; Shaw, Leslee J. ; Min, James K. ; Abidov, Aiden ; Germano, Guido ; Hayes, Sean W. ; Friedman, John D. ; Thomson, Louise E J ; Kang, Xingping ; Slomka, Piotr J. ; Rozanski, Alan. / Comparative use of radionuclide stress testing, coronary artery calcium scanning, and noninvasive coronary angiography for diagnostic and prognostic cardiac assessment. Cardiac CT Imaging: Diagnosis of Cardiovascular Disease: Second Edition. Springer London, 2010. pp. 233-254
@inbook{dab0045f4fa64b059fb79357b08ec09a,
title = "Comparative use of radionuclide stress testing, coronary artery calcium scanning, and noninvasive coronary angiography for diagnostic and prognostic cardiac assessment",
abstract = "Single-photon emission computed tomography (SPECT) or positron emission tomography (PET) myocardial perfusion scintigraphy (MPS) is a well-established noninvasive imaging modality that is a core element in evaluation of patients with stable chest pain syndromes. Stress SPECT MPS is the most commonly utilized stress imaging technique for patients with suspected or known coronary artery disease (CAD) and has a robust evidence base including the support of numerous clinical guidelines. By comparison, cardiac computed tomography (CT) is a more recently developed method, providing noninvasive approaches for imaging coronary atherosclerosis and coronary artery stenosis. After being in use for well over a decade, noncontrast CT for imaging the extent of coronary artery calcification (CAC) has an extensive evidence base supporting its use in CAD prevention. Contrast-enhanced CT for noninvasive CT coronary angiography (CCTA) is relatively new, but has a rapidly growing evidence base regarding diagnosing obstructive CAD and assessing risk. It is likely that noncontrast CT or CCTA for assessment of extent of atherosclerosis will become an increasing part of mainstream cardiovascular imaging practices as a first-line test. In some patients, further ischemia testing with MPS will be required. Similarly, MPS will continue to be widely used as a first-line test, and, in some patients, further anatomic definition of atherosclerosis with CT will also be appropriate. This review also provides a synopsis of the available literature on imaging that integrates both CT and MPS in strategies for the assessment of asymptomatic patients for their atherosclerotic coronary disease burden and risk as well as symptomatic patients for diagnosis and guiding management. We propose possible risk-based strategies through which imaging might be used to identify asymptomatic candidates for more intensive prevention and risk factor modification strategies as well as symptomatic patients who would benefit from referral to invasive coronary angiography (ICA) for consideration of revascularization.",
author = "Berman, {Daniel S.} and Shaw, {Leslee J.} and Min, {James K.} and Aiden Abidov and Guido Germano and Hayes, {Sean W.} and Friedman, {John D.} and Thomson, {Louise E J} and Xingping Kang and Slomka, {Piotr J.} and Alan Rozanski",
year = "2010",
doi = "10.1007/978-1-84882-650-2_19",
language = "English (US)",
isbn = "9781848826496",
pages = "233--254",
booktitle = "Cardiac CT Imaging: Diagnosis of Cardiovascular Disease: Second Edition",
publisher = "Springer London",

}

TY - CHAP

T1 - Comparative use of radionuclide stress testing, coronary artery calcium scanning, and noninvasive coronary angiography for diagnostic and prognostic cardiac assessment

AU - Berman, Daniel S.

AU - Shaw, Leslee J.

AU - Min, James K.

AU - Abidov, Aiden

AU - Germano, Guido

AU - Hayes, Sean W.

AU - Friedman, John D.

AU - Thomson, Louise E J

AU - Kang, Xingping

AU - Slomka, Piotr J.

AU - Rozanski, Alan

PY - 2010

Y1 - 2010

N2 - Single-photon emission computed tomography (SPECT) or positron emission tomography (PET) myocardial perfusion scintigraphy (MPS) is a well-established noninvasive imaging modality that is a core element in evaluation of patients with stable chest pain syndromes. Stress SPECT MPS is the most commonly utilized stress imaging technique for patients with suspected or known coronary artery disease (CAD) and has a robust evidence base including the support of numerous clinical guidelines. By comparison, cardiac computed tomography (CT) is a more recently developed method, providing noninvasive approaches for imaging coronary atherosclerosis and coronary artery stenosis. After being in use for well over a decade, noncontrast CT for imaging the extent of coronary artery calcification (CAC) has an extensive evidence base supporting its use in CAD prevention. Contrast-enhanced CT for noninvasive CT coronary angiography (CCTA) is relatively new, but has a rapidly growing evidence base regarding diagnosing obstructive CAD and assessing risk. It is likely that noncontrast CT or CCTA for assessment of extent of atherosclerosis will become an increasing part of mainstream cardiovascular imaging practices as a first-line test. In some patients, further ischemia testing with MPS will be required. Similarly, MPS will continue to be widely used as a first-line test, and, in some patients, further anatomic definition of atherosclerosis with CT will also be appropriate. This review also provides a synopsis of the available literature on imaging that integrates both CT and MPS in strategies for the assessment of asymptomatic patients for their atherosclerotic coronary disease burden and risk as well as symptomatic patients for diagnosis and guiding management. We propose possible risk-based strategies through which imaging might be used to identify asymptomatic candidates for more intensive prevention and risk factor modification strategies as well as symptomatic patients who would benefit from referral to invasive coronary angiography (ICA) for consideration of revascularization.

AB - Single-photon emission computed tomography (SPECT) or positron emission tomography (PET) myocardial perfusion scintigraphy (MPS) is a well-established noninvasive imaging modality that is a core element in evaluation of patients with stable chest pain syndromes. Stress SPECT MPS is the most commonly utilized stress imaging technique for patients with suspected or known coronary artery disease (CAD) and has a robust evidence base including the support of numerous clinical guidelines. By comparison, cardiac computed tomography (CT) is a more recently developed method, providing noninvasive approaches for imaging coronary atherosclerosis and coronary artery stenosis. After being in use for well over a decade, noncontrast CT for imaging the extent of coronary artery calcification (CAC) has an extensive evidence base supporting its use in CAD prevention. Contrast-enhanced CT for noninvasive CT coronary angiography (CCTA) is relatively new, but has a rapidly growing evidence base regarding diagnosing obstructive CAD and assessing risk. It is likely that noncontrast CT or CCTA for assessment of extent of atherosclerosis will become an increasing part of mainstream cardiovascular imaging practices as a first-line test. In some patients, further ischemia testing with MPS will be required. Similarly, MPS will continue to be widely used as a first-line test, and, in some patients, further anatomic definition of atherosclerosis with CT will also be appropriate. This review also provides a synopsis of the available literature on imaging that integrates both CT and MPS in strategies for the assessment of asymptomatic patients for their atherosclerotic coronary disease burden and risk as well as symptomatic patients for diagnosis and guiding management. We propose possible risk-based strategies through which imaging might be used to identify asymptomatic candidates for more intensive prevention and risk factor modification strategies as well as symptomatic patients who would benefit from referral to invasive coronary angiography (ICA) for consideration of revascularization.

UR - http://www.scopus.com/inward/record.url?scp=84892346424&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84892346424&partnerID=8YFLogxK

U2 - 10.1007/978-1-84882-650-2_19

DO - 10.1007/978-1-84882-650-2_19

M3 - Chapter

SN - 9781848826496

SP - 233

EP - 254

BT - Cardiac CT Imaging: Diagnosis of Cardiovascular Disease: Second Edition

PB - Springer London

ER -