The Role of Noninvasive Imaging in Coronary Artery Disease Detection, Prognosis, and Clinical Decision Making

Abstract A vast array of noninvasive imaging modalities is available for the evaluation of the presence and severity of coronary artery disease (CAD). Choosing the right test can be challenging but is critical for proper patient diagnosis and management. Presently available imaging tests for CAD inc...

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Bibliographic Details
Published in:Canadian journal of cardiology 2013-03, Vol.29 (3), p.285-296
Main Authors: Dowsley, Taylor, MD, PhD, Al-Mallah, Mouaz, MD, FACC, Ananthasubramaniam, Karthik, MD, FACC, FASNC, Dwivedi, Girish, MBBS, PhD, McArdle, Brian, MBBS, Chow, Benjamin J.W., MD, FRCPC, FACC, FASNC, FSCCT
Format: Article
Language:English
Subjects:
Algorithms
Cardiac Imaging Techniques
Cardiovascular
Coronary Angiography - methods
Coronary Artery Disease - diagnosis
Coronary Artery Disease - therapy
Diagnostic Imaging - methods
Echocardiography, Stress - methods
Electrocardiography
Exercise Test
Humans
Magnetic Resonance Angiography
Magnetic Resonance Imaging - methods
Patient Selection
Positron-Emission Tomography - methods
Predictive Value of Tests
Prognosis
Risk Assessment
Risk Factors
Sensitivity and Specificity
Tomography, Emission-Computed, Single-Photon - methods
Tomography, X-Ray Computed - methods
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Summary:Abstract A vast array of noninvasive imaging modalities is available for the evaluation of the presence and severity of coronary artery disease (CAD). Choosing the right test can be challenging but is critical for proper patient diagnosis and management. Presently available imaging tests for CAD include: (1) nuclear myocardial perfusion imaging procedures (single-photon emission tomography) and positron emission tomography, (2) stress echocardiography, (3) computed tomography coronary angiography, and (4) cardiac magnetic resonance imaging. Exercise treadmill testing electrocardiography is another alternative that we will discuss briefly. Selection of the most appropriate imaging modality requires knowledge of the clinical question being addressed, patient characteristics (pretest probability and prevalence of disease), the strengths, limitations, risks, costs, and availability of each procedure. To assist with test selection, we review the relevant literature in detail to consider the relative merits of cardiac imaging modalities for: (1) detection of CAD, (2) risk stratification and prognostication, and (3) guiding clinical decision making.
ISSN:0828-282X
1916-7075
DOI:10.1016/j.cjca.2012.10.022