Elsevier

Cardiology Clinics

Volume 27, Issue 2, May 2009, Pages 257-263
Cardiology Clinics

Hybrid Imaging: Integration of Nuclear Imaging and Cardiac CT

https://doi.org/10.1016/j.ccl.2008.12.001Get rights and content

The integration of nuclear medicine cameras with multidetector CT scanners provides a unique opportunity to delineate cardiac and vascular anatomic abnormalities and their physiologic consequences in a single setting. By revealing the burden of anatomic coronary artery disease and its physiologic significance, hybrid imaging can provide unique information that may improve noninvasive diagnosis, risk assessment, and management of coronary artery disease. By integrating the detailed anatomic information from CT with the high sensitivity of radionuclide imaging to evaluate targeted molecular and cellular abnormalities, hybrid imaging may play a key role in shaping the future of molecular diagnostics and therapeutics. This article reviews potential clinical applications of hybrid imaging in cardiovascular disease.

Section snippets

Rationale for integrating nuclear imaging and CT

For many decades, CT and nuclear imaging have followed separate and distinct developmental pathways. Both modalities have their strengths; CT scanners image cardiac and coronary anatomy with high spatial resolution, whereas nuclear imaging can identify a functional abnormality in, for example, myocardial perfusion, metabolism, or receptors. Although it may seem that in many cases it would be equally effective to view separately acquired CT and nuclear images for a given patient on adjacent

Diagnosing Obstructive Coronary Artery Disease

CTA provides excellent diagnostic sensitivity for stenoses in the proximal and mid segments (> 1.5 mm in diameter) of the main coronary arteries. Because of its relatively limited spatial resolution (compared with invasive angiography), the sensitivity of this approach is reduced substantially in more distal coronary segments and side branches.9 This limitation can be offset by the scintigraphic information that is generally not affected by the location of coronary stenoses. More importantly,

Summary

Innovation in noninvasive cardiovascular imaging is rapidly advancing our ability to image in great detail the structure and function in the heart and vasculature, and hybrid PET/CT and SPECT/CT represent clear examples of this innovation. By providing concurrent quantitative information about myocardial perfusion and metabolism with coronary and cardiac anatomy, hybrid imaging offers the opportunity for a comprehensive noninvasive evaluation of the burden of atherosclerosis and its physiologic

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