Excerpt

Myocardial perfusion scintigraphy at rest and after stress has provided for decades a robust means to assess the extent of myocardial ischemia due to obstructive coronary artery disease (CAD). The prognostic data collected through various jeopardy scores are overwhelmingly convincing of its power to accurately risk stratify patients with anginal symptoms. More recently, the development of high-resolution multidetector computed tomography (MDCT) scanners has reignited the interest of practicing physicians in the anatomy rather than the functional significance of luminal obstruction. Nonetheless, the importance of an abnormality in myocardial blood flow and tissue perfusion over mere anatomy has been reinforced in invasive clinical trials1,2 The significance of tissue perfusion has therefore promoted an interest in developing CT protocols that may allow a “one stop shop” assessment of anatomical severity and physiological significance of obstructive CAD.3 ^– 7 …