The Clinical Impact of Myocardial Perfusion Scintigraphy in the Evaluation of Coronary Artery Disease in 2009

Myocardial perfusion imaging (MPI) using single photon emission computed tomography (SPECT) or positron emission tomography (PET) techniques is a well-established diagnostic tool in clinical medicine providing non-invasively information about cardiac perfusion, function and prognosis in patients with coronary artery disease. Gated SPECT MPI has been used in clinical routine for years allowing the characterization of localization, extent and severity of perfusion abnormalities both in women and men. Recently, clinical studies employing nuclear techniques (e.g. BASKET or COURAGE) have underlined its diagnostic accuracy, prognostic validity and its importance for the clinical decision making. The extent of stress-induced ischaemia is of clinical relevance to guide decision making in the management of the cardiac patient. Improvements in nuclear imaging equipment, software for image analysis and stress techniques will accelerate the procedure and increase its diagnostic accuracy while reducing radiation exposure.