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Incremental Value of Hybrid PET/CT in Patients with Coronary Artery Disease

  • Cardiac Nuclear Imaging (A Cuocolo, Section Editor)
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Abstract

The noninvasive diagnosis of coronary artery disease (CAD) is a challenging task. Traditionally, myocardial perfusion imaging (MPI) has been widely used for this purpose whereby cardiac positron emission tomography (PET) is considered the gold standard. Alternatively, noninvasive anatomical imaging of coronary atherosclerosis with coronary computed tomography angiography (CCTA) has recently been successfully implemented in clinical practice. Cardiac hybrid imaging consists of the fusion of these modalities and provides detailed information on the presence and extent of CAD including its functional consequences on myocardial perfusion. This type of comprehensive imaging, obtained within a single session using a PET/CT scanner, appears to have superior diagnostic and prognostic value as compared with either stand-alone test. This review discusses the literature on the incremental value of hybrid cardiac PET/CT imaging for patients suspected of CAD.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Bashore TM, Bates ER, Berger PB, Clark DA, Cusma JT, Dehmer GJ, et al. American College of Cardiology/Society for Cardiac Angiography and Interventions Clinical Expert Consensus Document on cardiac catheterization laboratory standards. A report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol. 2001;37:2170–214.

    Article  CAS  PubMed  Google Scholar 

  2. Pijls NH, De Bruyne B, Peels K, Van Der Voort PH, Bonnier HJ, Bartunek J, et al. Measurement of fractional flow reserve to assess the functional severity of coronary-artery stenoses. N Engl J Med. 1996;334:1703–8.

    Article  CAS  PubMed  Google Scholar 

  3. Tonino PAL, De Bruyne B, Pijls NHJ, Siebert U, Ikeno F, van’ t Veer M, et al. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention. N Engl J Med. 2009;360:213–24.

    Article  CAS  PubMed  Google Scholar 

  4. De Bruyne B, Pijls NHJ, Kalesan B, Barbato E, Tonino PAL, Piroth Z, et al. Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease. N Engl J Med. 2012;367:991–1001.

    Article  PubMed  Google Scholar 

  5. Task Force Members, Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, et al. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J. Oxford University Press; 2013. pp. 2949–3003.

  6. Schroeder S, Achenbach S, Bengel F, Burgstahler C, Cademartiri F, de Feyter P, et al. Cardiac computed tomography: indications, applications, limitations, and training requirements: report of a Writing Group deployed by the Working Group Nuclear Cardiology and Cardiac CT of the European Society of Cardiology and the European Council of Nuclear Cardiology. Eur Heart J. Oxford University Press; 2008;29:531–56.

  7. Shaw LJ, Marwick TH, Zoghbi WA, Hundley WG, Kramer CM, Achenbach S, et al. Why all the focus on cardiac imaging? JACC Cardiovasc Imaging. 2010;3:789–94.

    Article  PubMed  Google Scholar 

  8. Danad I, Raijmakers PG, Harms HJ, van Kuijk C, van Royen N, Diamant M, et al. Effect of cardiac hybrid 15O-water PET/CT imaging on downstream referral for invasive coronary angiography and revascularization rate. Eur Heart J Cardiovasc Imaging. Oxford University Press; 2014;15:170–9.

  9. Jaarsma C, Leiner T, Bekkers SC, Crijns HJ, Wildberger JE, Nagel E, et al. Diagnostic performance of noninvasive myocardial perfusion imaging using single-photon emission computed tomography, cardiac magnetic resonance, and positron emission tomography imaging for the detection of obstructive coronary artery disease: a meta-analysis. J Am Coll Cardiol. 2012;59:1719–28.

    Article  PubMed  Google Scholar 

  10. Parker MW, Iskandar A, Limone B, Perugini A, Kim H, Jones C, et al. Diagnostic accuracy of cardiac positron emission tomography versus single photon emission computed tomography for coronary artery disease: a bivariate meta-analysis. Circ Cardiovasc Imaging. Lippincott Williams & Wilkins; 2012;5:700–7.

  11. Mc Ardle BA, Dowsley TF, DeKemp RA, Wells GA, Beanlands RS. Does rubidium-82 PET have superior accuracy to SPECT perfusion imaging for the diagnosis of obstructive coronary disease?: A systematic review and meta-analysis. J Am Coll Cardiol. 2012;60:1828–37.

    Article  PubMed  Google Scholar 

  12. Knaapen P, de Haan S, Hoekstra OS, Halbmeijer R, Appelman YE, Groothuis JGJ, et al. Cardiac PET-CT: advanced hybrid imaging for the detection of coronary artery disease. Neth Heart J. 2010;18:90–8.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. Bogaard K, van der Zant FM, Knol RJJ, Reinders S, Krul MMG, van Rossum AC, et al. High-pitch prospective ECG-triggered helical coronary computed tomography angiography in clinical practice: image quality and radiation dose. Int J Cardiovasc Imaging. Springer Netherlands; 2014;1–9.

  14. Danad I, Raijmakers PG, Knaapen P. Diagnosing coronary artery disease with hybrid PET/CT: it takes two to tango. J Nucl Cardiol. Springer US; 2013;20:874–90. Comprehensive review on the value of CCTA, PET, and hybrid imaging.

  15. Leber AW, Knez A, von Ziegler F, Becker A, Nikolaou K, Paul S, et al. Quantification of obstructive and nonobstructive coronary lesions by 64-slice computed tomography: a comparative study with quantitative coronary angiography and intravascular ultrasound. J Am Coll Cardiol. 2005;46:147–54.

    Article  PubMed  Google Scholar 

  16. Tonino PAL, Fearon WF, De Bruyne B, Oldroyd KG, Leesar MA, Ver Lee PN, et al. Angiographic versus functional severity of coronary artery stenoses in the FAME study fractional flow reserve versus angiography in multivessel evaluation. J Am Coll Cardiol. 2010;55:2816–21.

    Article  PubMed  Google Scholar 

  17. Gaemperli O, Schepis T, Valenta I, Koepfli P, Husmann L, Scheffel H, et al. Functionally relevant coronary artery disease: comparison of 64-section CT angiography with myocardial perfusion SPECT. Radiology. 2008;248:414–23.

    Article  PubMed  Google Scholar 

  18. Schuijf JD, Wijns W, Jukema JW, Atsma DE, de Roos A, Lamb HJ, et al. Relationship between noninvasive coronary angiography with multi-slice computed tomography and myocardial perfusion imaging. J Am Coll Cardiol. 2006;48:2508–14.

    Article  PubMed  Google Scholar 

  19. Shreibati JB, Baker LC, Hlatky MA. Association of coronary CT angiography or stress testing with subsequent utilization and spending among Medicare beneficiaries. JAMA. American Medical Association; 2011;306:2128–36.

  20. Hachamovitch R, Nutter B, Hlatky MA, Shaw LJ, Ridner ML, Dorbala S, et al. Patient management after noninvasive cardiac imaging results from SPARC (Study of myocardial perfusion and coronary anatomy imaging roles in coronary artery disease). J Am Coll Cardiol. 2012;59:462–74.

    Article  PubMed  Google Scholar 

  21. Nielsen LH, Ortner N, Nørgaard BL, Achenbach S, Leipsic J, Abdulla J. The diagnostic accuracy and outcomes after coronary computed tomography angiography vs. conventional functional testing in patients with stable angina pectoris: a systematic review and meta-analysis. Eur Heart J Cardiovasc Imaging. Oxford University Press; 2014;15:961–71.

  22. Hulten EA, Carbonaro S, Petrillo SP, Mitchell JD, Villines TC. Prognostic value of cardiac computed tomography angiography: a systematic review and meta-analysis. J Am Coll Cardiol. 2011;57:1237–47.

    Article  PubMed  Google Scholar 

  23. Min JK, Dunning A, Lin FY, Achenbach S, Al-Mallah M, Budoff MJ, et al. Age- and sex-related differences in all-cause mortality risk based on coronary computed tomography angiography findings results from the International Multicenter CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry) of 23,854 patients without known coronary artery disease. J Am Coll Cardiol. 2011;58:849–60. Prospective registry on the short-term prognostic value of CCTA.

    Article  PubMed  Google Scholar 

  24. Hadamitzky M, Täubert S, Deseive S, Byrne RA, Martinoff S, Schömig A, et al. Prognostic value of coronary computed tomography angiography during 5 years of follow-up in patients with suspected coronary artery disease. Eur Heart J. 2013;34:3277–85. Prospective registry on the long-term prognostic value of CCTA.

    Article  PubMed  Google Scholar 

  25. Blankstein R, Ferencik M. The vulnerable plaque: Can it be detected with Cardiac CT? Atherosclerosis. Elsevier; 2010;211:386–9.

  26. Versteylen MO, Kietselaer BL, Dagnelie PC, Joosen IA, Dedic A, Raaijmakers RH, et al. Additive value of semiautomated quantification of coronary artery disease using cardiac computed tomographic angiography to predict future acute coronary syndrome. J Am Coll Cardiol. 2013;61:2296–305.

    Article  PubMed  Google Scholar 

  27. Motoyama S, Sarai M, Harigaya H, Anno H, Inoue K, Hara T, et al. Computed tomographic angiography characteristics of atherosclerotic plaques subsequently resulting in acute coronary syndrome. J Am Coll Cardiol. 2009;54:49–57.

    Article  PubMed  Google Scholar 

  28. Knaapen P, Camici PG, Marques KM, Nijveldt R, Bax JJ, Westerhof N, et al. Coronary microvascular resistance: methods for its quantification in humans. Basic Res Cardiol D. Steinkopff-Verlag; 2009;104:485–98.

  29. Knaapen P, Lubberink M. Cardiac positron emission tomography: myocardial perfusion and metabolism in clinical practice. Clin Res Cardiol D. Steinkopff-Verlag; 2008;97:791–6.

  30. Rischpler C, Park M-J, Fung GSK, Javadi M, Tsui BMW, Higuchi T. Advances in PET myocardial perfusion imaging: F-18 labeled tracers. Ann Nucl Med. Springer Japan; 2012;26:1–6.

  31. Iida H, Kanno I, Takahashi A, Miura S, Murakami M, Takahashi K, et al. Measurement of absolute myocardial blood flow with H215O and dynamic positron-emission tomography. Strategy for quantification in relation to the partial-volume effect. Circulation. 1988;78:104–15.

    Article  CAS  PubMed  Google Scholar 

  32. Schindler TH, Schelbert HR, Quercioli A, Dilsizian V. Cardiac PET imaging for the detection and monitoring of coronary artery disease and microvascular health. JACC Cardiovasc Imaging. 2010;3:623–40.

    Article  PubMed  Google Scholar 

  33. Huang SC, Williams BA, Krivokapich J, Araujo L, Phelps ME, Schelbert HR. Rabbit myocardial 82Rb kinetics and a compartmental model for blood flow estimation. Am J Physiol. 1989;256:H1156–64.

    CAS  PubMed  Google Scholar 

  34. Schelbert HR, Phelps ME, Huang SC, MacDonald NS, Hansen H, Selin C, et al. N-13 ammonia as an indicator of myocardial blood flow. Circulation. 1981;63:1259–72.

    Article  CAS  PubMed  Google Scholar 

  35. Yalamanchili P, Wexler E, Hayes M, Yu M, Bozek J, Kagan M, et al. Mechanism of uptake and retention of F-18 BMS-747158-02 in cardiomyocytes: a novel PET myocardial imaging agent. J Nucl Cardiol. Springer-Verlag; 2007;14:782–8.

  36. Di Carli MF, Hachamovitch R. New technology for noninvasive evaluation of coronary artery disease. Circulation. Lippincott Williams & Wilkins; 2007;115:1464–80.

  37. Nesterov SV, Han C, Mäki M, Kajander S, Naum AG, Helenius H, et al. Myocardial perfusion quantitation with 15O-labelled water PET: high reproducibility of the new cardiac analysis software (Carimas). Eur J Nucl Med Mol Imaging. Springer-Verlag; 2009;36:1594–602.

  38. Harms HJ, Knaapen P, de Haan S, Halbmeijer R, Lammertsma AA, Lubberink M. Automatic generation of absolute myocardial blood flow images using [15O]H2O and a clinical PET/CT scanner. Eur J Nucl Med Mol Imaging. Springer-Verlag; 2011;38:930–9.

  39. Harms HJ, Nesterov SV, Han C, Danad I, Leonora R, Raijmakers PG, et al. Comparison of clinical non-commercial tools for automated quantification of myocardial blood flow using oxygen-15-labelled water PET/CT. Eur Heart J Cardiovasc Imaging. Oxford University Press; 2013;jet177.

  40. Danad I, Raijmakers PG, Appelman YE, Harms HJ, de Haan S, van den Oever MLP, et al. Hybrid imaging using quantitative H215O PET and CT-based coronary angiography for the detection of coronary artery disease. J Nucl Med Society of Nuclear Medicine; 2013;54:55–63.

  41. Kajander S, Joutsiniemi E, Saraste M, Pietilä M, Ukkonen H, Saraste A, et al. Cardiac positron emission tomography/computed tomography imaging accurately detects anatomically and functionally significant coronary artery disease. Circulation. Lippincott Williams & Wilkins; 2010;122:603–13.

  42. Danad I, Raijmakers PG, Harms HJ, Heymans MW, van Royen N, Lubberink M, et al. Impact of anatomical and functional severity of coronary atherosclerotic plaques on the transmural perfusion gradient: a [15O]H2O PET study. Eur Heart J. Oxford University Press; 2014;35:2094–105.

  43. Maddahi J. Properties of an ideal PET perfusion tracer: new PET tracer cases and data. J Nucl Cardiol. 2012;19 Suppl 1:S30–7.

    Article  PubMed  Google Scholar 

  44. Bergmann SR, Fox KA, Rand AL, McElvany KD, Welch MJ, Markham J, et al. Quantification of regional myocardial blood flow in vivo with H215O. Circulation. 1984;70:724–33.

    Article  CAS  PubMed  Google Scholar 

  45. Saraste A, Kajander S, Han C, Nesterov SV, Knuuti J. PET: Is myocardial flow quantification a clinical reality? J Nucl Cardiol. Springer-Verlag; 2012;19:1044–59.

  46. Bol A, Melin JA, Vanoverschelde JL, Baudhuin T, Vogelaers D, De Pauw M, et al. Direct comparison of [13N]ammonia and [15O]water estimates of perfusion with quantification of regional myocardial blood flow by microspheres. Circulation. 1993;87:512–25.

    Article  CAS  PubMed  Google Scholar 

  47. Kaufmann PA, Gnecchi-Ruscone T, Yap JT, Rimoldi O, Camici PG. Assessment of the reproducibility of baseline and hyperemic myocardial blood flow measurements with 15O-labeled water and PET. J Nucl Med. 1999;40:1848–56.

    CAS  PubMed  Google Scholar 

  48. Hutchins GD, Schwaiger M, Rosenspire KC, Krivokapich J, Schelbert H, Kuhl DE. Noninvasive quantification of regional blood flow in the human heart using N-13 ammonia and dynamic positron emission tomographic imaging. J Am Coll Cardiol. 1990;15:1032–42.

    Article  CAS  PubMed  Google Scholar 

  49. Lautamäki R, George RT, Kitagawa K, Higuchi T, Merrill J, Voicu C, et al. Rubidium-82 PET-CT for quantitative assessment of myocardial blood flow: validation in a canine model of coronary artery stenosis. Eur J Nucl Med Mol Imaging. Springer-Verlag; 2009;36:576–86.

  50. Nekolla SG, Reder S, Saraste A, Higuchi T, Dzewas G, Preissel A, et al. Evaluation of the novel myocardial perfusion positron-emission tomography tracer 18F-BMS-747158-02: comparison to 13N-ammonia and validation with microspheres in a pig model. Circulation. 2009;119:2333–42.

    Article  CAS  PubMed  Google Scholar 

  51. Gould KL, Johnson NP, Bateman TM, Beanlands RS, Bengel FM, Bober R, et al. Anatomic versus physiologic assessment of coronary artery disease. Role of coronary flow reserve, fractional flow reserve, and positron emission tomography imaging in revascularization decision-making. J Am Coll Cardiol. 2013;62:1639–53. Comprehensive review on the interpretation of (quantitative) perfusion PET in relation to FFR.

    Article  PubMed  Google Scholar 

  52. Muzik O, Duvernoy C, Beanlands RS, Sawada S, Dayanikli F, Wolfe ER, et al. Assessment of diagnostic performance of quantitative flow measurements in normal subjects and patients with angiographically documented coronary artery disease by means of nitrogen-13 ammonia and positron emission tomography. J Am Coll Cardiol. 1998;31:534–40.

    Article  CAS  PubMed  Google Scholar 

  53. Kajander SA, Joutsiniemi E, Saraste M, Pietilä M, Ukkonen H, Saraste A, et al. Clinical value of absolute quantification of myocardial perfusion with (15)O-water in coronary artery disease. Circ Cardiovasc Imaging. Lippincott Williams & Wilkins; 2011;4:678–84.

  54. Hajjiri MM, Leavitt MB, Zheng H, Spooner AE, Fischman AJ, Gewirtz H. Comparison of positron emission tomography measurement of adenosine-stimulated absolute myocardial blood flow versus relative myocardial tracer content for physiological assessment of coronary artery stenosis severity and location. JACC Cardiovasc Imaging. 2009;2:751–8.

    Article  PubMed  Google Scholar 

  55. Fiechter M, Ghadri JR, Gebhard C, Fuchs TA, Pazhenkottil AP, Nkoulou RN, et al. Diagnostic value of 13N-ammonia myocardial perfusion PET: added value of myocardial flow reserve. J Nucl Med Soc Nucl Med. 2012;53:1230–4.

    Article  CAS  Google Scholar 

  56. Joutsiniemi E, Saraste A, Pietilä M, Mäki M, Kajander S, Ukkonen H, et al. Absolute flow or myocardial flow reserve for the detection of significant coronary artery disease? Eur Heart J Cardiovasc Imaging. Oxford University Press; 2014;15:659–65.

  57. Danad I, Uusitalo V, Kero T, Saraste A, Raijmakers PG, Lammertsma AA, et al. Quantitative assessment of myocardial perfusion in the detection of significant coronary artery disease: cutoff values and diagnostic accuracy of quantitative [(15)O]H2O PET imaging. J Am Coll Cardiol. 2014;64:1464–75. First multi-center trial on the diagnostic thresholds of quantitative perfusion PET to detect CAD with standard FFR measurements in all patients.

    Article  PubMed  Google Scholar 

  58. Knaapen P. Quantitative myocardial blood flow imaging: not all flow is equal. Eur J Nucl Med Mol Imaging. Springer Berlin Heidelberg; 2014;41:116–8.

  59. 59. Danad I, Raijmakers PG, Appelman YE, Harms HJ, de Haan S, van den Oever MLP, et al. Coronary risk factors and myocardial blood flow in patients evaluated for coronary artery disease: a quantitative [15O]H2O PET/CT study. Eur J Nucl Med Mol Imaging. Springer-Verlag; 2012;39:102–12.

  60. Liga R, Rovai D, Sampietro T, Vecoli C, Todiere G, Caselli C, et al. Insulin resistance is a major determinant of myocardial blood flow impairment in anginal patients. Eur J Nucl Med Mol Imaging. Springer Berlin Heidelberg; 2013;40:1905–13.

  61. Shaw LJ, Iskandrian AE. Prognostic value of gated myocardial perfusion SPECT. J Nucl Cardiol. Springer-Verlag; 2004;11:171–85.

  62. Ziadi MC, DeKemp RA, Williams KA, Guo A, Chow BJW, Renaud JM, et al. Impaired myocardial flow reserve on rubidium-82 positron emission tomography imaging predicts adverse outcomes in patients assessed for myocardial ischemia. J Am Coll Cardiol. 2011;58:740–8.

    Article  PubMed  Google Scholar 

  63. Herzog BA, Husmann L, Valenta I, Gaemperli O, Siegrist PT, Tay FM, et al. Long-term prognostic value of 13N-ammonia myocardial perfusion positron emission tomography added value of coronary flow reserve. J Am Coll Cardiol. 2009;54:150–6.

    Article  PubMed  Google Scholar 

  64. Farhad H, Dunet V, Bachelard K, Allenbach G, Kaufmann PA, Prior JO. Added prognostic value of myocardial blood flow quantitation in rubidium-82 positron emission tomography imaging. Eur Heart J Cardiovasc Imaging. Oxford University Press; 2013;14:1203–10.

  65. Fukushima K, Javadi MS, Higuchi T, Lautamäki R, Merrill J, Nekolla SG, et al. Prediction of short-term cardiovascular events using quantification of global myocardial flow reserve in patients referred for clinical 82Rb PET perfusion imaging. J Nucl Med Soc Nucl Med. 2011;52:726–32.

    Article  Google Scholar 

  66. Glagov S, Weisenberg E, Zarins CK, Stankunavicius R, Kolettis GJ. Compensatory enlargement of human atherosclerotic coronary arteries. N Engl J Med. 1987;316:1371–5.

    Article  CAS  PubMed  Google Scholar 

  67. Groves AM, Speechly-Dick M-E, Kayani I, Pugliese F, Endozo R, McEwan J, et al. First experience of combined cardiac PET/64-detector CT angiography with invasive angiographic validation. Eur J Nucl Med Mol Imaging. Springer-Verlag; 2009;36:2027–33.

  68. Thomassen A, Petersen H, Diederichsen ACP, Mickley H, Jensen LO, Johansen A, et al. Hybrid CT angiography and quantitative 15O-water PET for assessment of coronary artery disease: comparison with quantitative coronary angiography. Eur J Nucl Med Mol Imaging. Springer Berlin Heidelberg; 2013;40:1894–904.

  69. Rispler S, Keidar Z, Ghersin E, Roguin A, Soil A, Dragu R, et al. Integrated single-photon emission computed tomography and computed tomography coronary angiography for the assessment of hemodynamically significant coronary artery lesions. J Am Coll Cardiol. 2007;49:1059–67.

    Article  PubMed  Google Scholar 

  70. Sato A, Nozato T, Hikita H, Miyazaki S, Takahashi Y, Kuwahara T, et al. Incremental value of combining 64-slice computed tomography angiography with stress nuclear myocardial perfusion imaging to improve noninvasive detection of coronary artery disease. J Nucl Cardiol. Springer-Verlag; 2010;17:19–26.

  71. Schaap J, Kauling RM, Boekholdt SM, Nieman K, Meijboom WB, Post MC, et al. Incremental diagnostic accuracy of hybrid SPECT/CT coronary angiography in a population with an intermediate to high pre-test likelihood of coronary artery disease. Eur Heart J Cardiovasc Imaging. 2013;14:642–9.

    Article  PubMed  Google Scholar 

  72. Schaap J, de Groot JAH, Nieman K, Meijboom WB, Boekholdt SM, Kauling RM, et al. Added value of hybrid myocardial perfusion SPECT and CT coronary angiography in the diagnosis of coronary artery disease. Eur Heart J Cardiovasc Imaging. 2014;15:1281–8.

    Article  PubMed  Google Scholar 

  73. Groothuis JGJ, Beek AM, Brinckman SL, Meijerink MR, van den Oever MLP, Hofman MBM, et al. Combined non-invasive functional and anatomical diagnostic work-up in clinical practice: the magnetic resonance and computed tomography in suspected coronary artery disease (MARCC) study. Eur Heart J. 2013;34:1990–8.

    Article  CAS  PubMed  Google Scholar 

  74. Schenker MP, Dorbala S, Hong ECT, Rybicki FJ, Hachamovitch R, Kwong RY, et al. Interrelation of coronary calcification, myocardial ischemia, and outcomes in patients with intermediate likelihood of coronary artery disease: a combined positron emission tomography/computed tomography study. Circulation. Lippincott Williams & Wilkins; 2008;117:1693–700.

  75. Naya M, Murthy VL, Foster CR, Gaber M, Klein J, Hainer J, et al. Prognostic interplay of coronary artery calcification and underlying vascular dysfunction in patients with suspected coronary artery disease. J Am Coll Cardiol. 2013;61:2098–106.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  76. van Werkhoven JM, Schuijf JD, Gaemperli O, Jukema JW, Boersma E, Wijns W, et al. Prognostic value of multislice computed tomography and gated single-photon emission computed tomography in patients with suspected coronary artery disease. J Am Coll Cardiol. 2009;53:623–32.

    Article  PubMed  Google Scholar 

  77. Pazhenkottil AP, Nkoulou RN, Ghadri J-R, Herzog BA, Buechel RR, Küest SM, et al. Prognostic value of cardiac hybrid imaging integrating single-photon emission computed tomography with coronary computed tomography angiography. Eur Heart J. Oxford University Press; 2011;32:1465–71.

  78. Kim H-L, Kim Y-J, Lee S-P, Park E-A, Paeng J-C, Kim H-K, et al. Incremental prognostic value of sequential imaging of single-photon emission computed tomography and coronary computed tomography angiography in patients with suspected coronary artery disease. Eur Heart J Cardiovasc Imaging. Oxford University Press; 2014;15:878–85.

  79. Rochitte CE, George RT, Chen MY, Arbab-Zadeh A, Dewey M, Miller JM, et al. Computed tomography angiography and perfusion to assess coronary artery stenosis causing perfusion defects by single photon emission computed tomography: the CORE320 study. Eur Heart J. 2014;35:1120–30.

    Article  PubMed  Google Scholar 

  80. Taylor CA, Fonte TA, Min JK. Computational fluid dynamics applied to cardiac computed tomography for noninvasive quantification of fractional flow reserve: scientific basis. J Am Coll Cardiol. 2013;61:2233–41.

    Article  PubMed  Google Scholar 

  81. Koo B-K, Erglis A, Doh J-H, Daniels DV, Jegere S, Kim H-S, et al. Diagnosis of ischemia-causing coronary stenoses by noninvasive fractional flow reserve computed from coronary computed tomographic angiograms. Results from the prospective multicenter DISCOVER-FLOW (Diagnosis of Ischemia-Causing Stenoses Obtained Via Noninvasive Fractional Flow Reserve) study. J Am Coll Cardiol. 2011;58:1989–97.

    Article  PubMed  Google Scholar 

  82. Min JK, Leipsic J, Pencina MJ, Berman DS, Koo B-K, van Mieghem C, et al. Diagnostic accuracy of fractional flow reserve from anatomic CT angiography. JAMA. 2012;308:1237–45. Multi-center trial demonstrating the limited incremental value of FFRct over CCTA alone.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  83. Nørgaard BL, Leipsic J, Gaur S, Seneviratne S, Ko BS, Ito H, et al. Diagnostic performance of noninvasive fractional flow reserve derived from coronary computed tomography angiography in suspected coronary artery disease: the NXT trial (Analysis of Coronary Blood Flow Using CT Angiography: Next Steps). J Am Coll Cardiol. 2014;63:1145–55. Multi-center trial demonstrating slightly enhanced diagnostic accuracy of FFRct over CCTA alone.

    Article  PubMed  Google Scholar 

  84. Wong DTL, Ko BS, Cameron JD, Nerlekar N, Leung MCH, Malaiapan Y, et al. Transluminal attenuation gradient in coronary computed tomography angiography is a novel noninvasive approach to the identification of functionally significant coronary artery stenosis: a comparison with fractional flow reserve. J Am Coll Cardiol. 2013;61:1271–9.

    Article  PubMed  Google Scholar 

  85. Stuijfzand WJ, Danad I, Raijmakers PG, Marcu CB, Heymans MW, van Kuijk CC, et al. Additional value of transluminal attenuation gradient in CT angiography to predict hemodynamic significance of coronary artery stenosis. JACC Cardiovasc Imaging. 2014;7:374–86.

    Article  PubMed  Google Scholar 

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Paul Knaapen, Wynand J. Stuijfzand, Roel Driessen, Ibrahim Danad, and Pieter G. Raijmakers declare that they have no conflict of interest.

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  1. Department of Cardiology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands

    Paul Knaapen, Wynand J. Stuijfzand, Roel S. Driessen, Ibrahim Danad & Pieter G. Raijmakers

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Knaapen, P., Stuijfzand, W.J., Driessen, R.S. et al. Incremental Value of Hybrid PET/CT in Patients with Coronary Artery Disease. Curr Cardiovasc Imaging Rep 8, 9312 (2015). https://doi.org/10.1007/s12410-014-9312-y

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