Hybrid methods and modalities are the most effective in attaining cardiovascular images, according to a lecture given by Daniel Berman, MD, chief of cardiac imaging and nuclear cardiology during “The Latest Advances in Cardiovascular CT” on Saturday at the Transcatheter Cardiovascular Therapeutics (TCT) conference in Washington, D.C.

Berman suggested that the strengths of PET/CT and SPECT are higher resolution; routine attenuation correction; and peak stress function. The only drawback that Berman listed was the expensive nature of these modalities.

Berman said that almost all PET systems now have CT.

Both SPECT and PET/CT are needed when the initial test fails to answer the diagnoses question, according to Berman. However, he said “most cases do not require both modalities, plus it is more expensive and the patient will endure a higher radiation dose.

According to Berman, patients with ischemia perform better with medical prescriptions and patients without ischemia perform better with revascularization.

Berman highlighted the value of fusing data from two imaging modalities. The fusion of CT angiogram and myocardial perfusion studies can resolve the inconclusive of the singular myocardial perfusion imaging or CTA findings. Berman said that CTA improves MPI through image fusion that allows guided contour and territory adjustment.

Berman concluded that hybrid systems and methods have the most effective attenuation correction.