ABSTRACT

It’s physiological imaging principle and the large pool of clinical evidence, makes the myocardial perfusion single photon emission tomography (MPS) one of the first step modalities of algorithms in the noninvasive diagnosis and risk stratification of coronary artery disease (CAD). Besides its widely accepted diagnostic usefulness, diagnostic algorithms including MPS were proven to be the most cost-effective solutions in large-scale studies. The most important factors affecting the diagnostic sensitivity of MPS are soft tissue attenuation artifacts, low-grade stenosis, and balanced multi-vessel disease. Computerized tomographic coronary angiography (CCA) and CT calcium scoring (CCS) studies have been performed increasingly in recent years and they are reported to be successful in the diagnosis of early and advanced stages of CAD. Although CCA has proven to have a very high negative predictive value, it is reported that the method is not such successful in detecting the tissue perfusion counterpart of diagnosed stenotic changes. In this review, the CCA method, as well as hybrid systems hosting MPS/CT (CCA) in one device were introduced and their additional diagnostic value was discussed.