• Imaging of Coronary Artery Disease: The Big Picture

    j.jacr.2010.02.002

    Imaging of Coronary Artery Disease: The Big Picture

    Eugene Lin, MD

    In patients with known or suspected coronary artery disease (CAD), what should be imaged, and how should we image it? Is there any role for im­aging in asymptomatic people at risk? Should we image atherosclerosis, anatomy, or ischemia, or some com­bination thereof? Should we use CT, MRI, single photon-emission computed tomography (SPECT), PET, or some combination of these modalities? How will current and fu­ture economic and policy issues bear on these questions?
    Anatomy is typically imaged by evaluating the degree of luminal ste­nosis. Ischemia can be imaged by evaluating perfusion or motion. There are many ways to image ath­erosclerosis (plaque). When consid­ering which of these processes to image, it is useful to consider asymp­tomatic and symptomatic patients separately.