Nuclear cardiology will remain the “gatekeeper” over CT angiography

@article{Hachamovitch2007NuclearCW,
  title={Nuclear cardiology will remain the “gatekeeper” over CT angiography},
  author={R. Hachamovitch and M. Carli},
  journal={Journal of Nuclear Cardiology},
  year={2007},
  volume={14},
  pages={634-644}
}
ConclusionAlthough CTA is a promising new modality, from an evidence-based point of view there is no data to support its use in a testing strategy, its accuracy is unlikely to be sufficiently similar to invasive catheterization to be considered its equivalent, and most importantly, it appears that stress perfusion data will be needed to select which patients may most benefit from revascularization and, hence, referral to the catheterization laboratory. 

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References

SHOWING 1-10 OF 28 REFERENCES
Myocardial perfusion imaging and multidetector computed tomographic coronary angiography: appropriate for all patients with suspected coronary artery disease?
TLDR
An impressive introduction of new imaging technology for the evaluation of patients with known or suspected coronary artery disease (CAD) and the introduction of multidetector computed tomographic scanners with submillimeter spatial resolution and subsecond. Expand
Coronary flow studies for risk stratification in multivessel disease. A physiologic bridge too far?
  • D. Miller
  • Medicine
  • Journal of the American College of Cardiology
  • 2002
In this era of intense historical reflection on the events of World War II, noted authors and film makers have transported a new generation back to the heroic acts and inglorious failures of the lastExpand
New technology for noninvasive evaluation of coronary artery disease.
TLDR
Current and potential future applications of cardiovascular CT, PET, and hybrid PET/CT, with a particular focus on ischemic heart disease are discussed, including the potential for a comprehensive noninvasive cardiac evaluation of anatomy and function. Expand
Accuracy of 16-row multidetector computed tomography for the assessment of coronary artery stenosis.
TLDR
The results of this study indicate that MDCT coronary angiography performed with 16-row scanners is limited by a high number of nonevaluable cases and a high false-positive rate. Expand
Quantification of obstructive and nonobstructive coronary lesions by 64-slice computed tomography: a comparative study with quantitative coronary angiography and intravascular ultrasound.
OBJECTIVES The aim of the present study was to determine the diagnostic accuracy of 64-slice computed tomography (CT) to identify and quantify atherosclerotic coronary lesions in comparison withExpand
Noninvasive detection of coronary lesions using 16-detector multislice spiral computed tomography technology: initial clinical results.
TLDR
In individuals with low-to-moderate amounts of coronary artery calcium, 16-detector CT coronary angiography has high sensitivity and specificity for the diagnosis of significant coronary artery stenosis. Expand
Comparison between angiography and fractional flow reserve versus single-photon emission computed tomographic myocardial perfusion imaging for determining lesion significance in patients with multivessel coronary disease.
TLDR
Many patients with MVD show no perfusion defect in zones supplied by arteries with total occlusion or a FFR<0.75, suggesting MPI underestimates ischemic burden and FFR may be better at guiding revascularization decisions than perfusion imaging in patients withMVD. Expand
Severity of coronary artery calcification by electron beam computed tomography predicts silent myocardial ischemia.
TLDR
The results support the role of EBCT as the initial screening tool for identifying individuals at various stages of CAD development for whom therapeutic decision making may differ considerably. Expand
Fractional Flow Reserve to Determine the Appropriateness of Angioplasty in Moderate Coronary Stenosis A Randomized Trial
TLDR
Coronary pressure–derived fractional flow reserve (FFR) is an invasive index of stenosis severity that is a reliable substitute for noninvasive stress testing and identifies stenoses with hemodynamic significance. Expand
Usefulness of fractional flow reserve for risk stratification of patients with multivessel coronary artery disease and an intermediate stenosis.
TLDR
Results suggest that FFR is more useful than single-photon emission computed tomography for clinical decision-making and risk stratification in patients with multivessel CAD and predicts cardiac events related to the intermediate lesion. Expand
...
1
2
3
...