Cardiac CT, nuke med help with decision-making

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At ACC06 in Atlanta this week several experts discussed the complexities and benefits of using imaging technology — especially cardiac CT and nuclear imaging — in diagnosing chronic coronary artery disease (CAD). This discussion was part of the conferences Spotlight Sessions.
   
Generally, different patients with different symptoms benefit from one modality more than another, and a helpful thing to know is the quirks of a modality. For instance, when using SPECT — though there is greater precision as with all image technologies — knowing that you have to apply the attenuation correction is important, noted H. William Strauss, MD, clinical director of nuclear medicine at Memorial-Sloan Kettering Cancer Center in New York City.
   
For specific types of patients such as symptomatic patients with an intermediate likelihood of coronary artery disease, CT angiography could be beneficial to help with deciding the next proper course of action for a patient.
   
“This technology may be quite good at ruling out the presence of coronary artery disease. Patients who are negative by CT could be discharged, and those who are positive could go for further testing,” said Joao A. Lima, MD, associate professor of medicine and radiology and director of cardiovascular imaging at John Hopkins School of Medicine.
   
More generally, the cardiologist’s role in patient treatment, according to Lima:

  • Remind patients of the benefits of exercize;
  • Help determine if a patient has CAD;
  • Help a patient understand their risks for a cardiac event; and
  • Help physicians to make decisions regarding care.