CT Imaging of Myocardial Perfusion and Viability: Future Perspectives
The notion of evidence-based medicine (EBM) has transformed the science and practice of medicine substantially over the past decades. EBM has been defined as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients" (Sackett et al. 1996). EBM thus demands that medical procedures be justified by objective measures of performance. This general trend in healthcare has long been ignored by the radiological field, with the formal concept of evidence-based radiology (EBR), only recently established (Evidence-Based Radiology Working Group 2001; Sheehan et al. 2007; Collins 2007; Malone 2007; Dodd et al. 2004). At least in part, this may be explained by the conceptual framework of EBM, which is primarily designed to assess the efficacy of therapeutic procedures, such as pharmacological, surgical, or other interventions. Many criteria used to assess the quality of studies and levels of evidence in EBM are not directly applicable to diagnostic imaging.
KeywordsMyocardial Perfusion Myocardial Perfusion Imaging Fractional Flow Reserve Blood Pool Imaging Fractional Flow Reserve Measurement
- Evidence-Based Radiology Working Group (2001) Evidence-based radiology: a new approach to the practice of radiology. Radiology 220:566–575Google Scholar
- Lima J, Maurer G (2012) Diagnostic performance of combined noninvasive coronary angiography and myocardial perfusion imaging using 320-row detector computer tomography: The CORE320 Multicenter, Multinational Study. ESC 2012 (Abstract 3936)Google Scholar
- Meyer M, Nance JW Jr, Schoepf UJ, Moscariello A, Weininger M, Rowe GW, Ruzsics B, Kang DK, Chiaramida SA, Schoenberg SO, Fink C, Henzler T (2012) Cost-effectiveness of substituting dual-energy CT for SPECT in the assessment of myocardial perfusion for the workup of coronary artery disease. Eur J Radiol 81:3719–3725PubMedCrossRefGoogle Scholar
- Vavere AL, Simon GG, George RT, Rochitte CE, Arai AE, Miller JM, Di Carli M, Arbab-Zadeh A, Dewey M, Niinuma H, Laham R, Rybicki FJ, Schuijf JD, Paul N, Hoe J, Kuribyashi S, Sakuma H, Nomura C, Yaw TS, Kofoed KF, Yoshioka K, Clouse ME, Brinker J, Cox C, Lima JA (2011) Diagnostic performance of combined noninvasive coronary angiography and myocardial perfusion imaging using 320 row detector computed tomography: design and implementation of the CORE320 multicenter, multinational diagnostic study. J Cardiovasc Comput Tomogr 5:370–381PubMedCrossRefGoogle Scholar