Abstract
Diagnostic modalities including SPECT and CT are both useful for detecting coronary artery disease. Physiological and anatomical approaches are two sides of same coin. In a twist of irony, increasing of CT angiography and decreasing of SPECT field in Japan would be associated with in appropriate coronary interventions in terms of American appropriate use criteria of coronary interventions. Quantification of perfusion abnormality and myocardial flow reserve using dedicated CZT gamma camera would make it possible to identify the patients, in whom interventions may improve the long-term prognosis. Recent publication reported that initial non-invasive diagnostic modalities (SPECT or CT) did not affect patients’ outcome. Medical economical approach should be taken into account for the selection of those two modalities in future.
