Myocardial perfusion SPEC imaging for diagnosis CAD and evaluation of prognosis in patients with acute coronary syndrome

Myocardial cell hypo-perfusion is considered the direct consequence of coronary artery disease (CAD). Myocardial perfusion has been assessed by myocardial perfusion SPECT (MPS) for years. In the advent of sophisticated functional procedures including fractional flow reserve assessment, PET imaging, and delicate anatomic imaging modalities, diagnostic performance of MPS has been under appraisal. Albeit, the diagnostic accuracy of MPS for detection of CAD, particularly in moderate risk populations and post revascularization patients, and assessment of prognosis and efficacy of medical treatment has kept the MPS yet alive among the armamentariums for the evaluation of CAD. MPS has attracting practical application for evaluation of patients with acute coronary syndrome(ACS) even at the emergency departments when the patient is admitted for chest pain. As its major drawback, MPS imposes patients into radiation twice the radiation a usual person receives from cosmic rays annually; nevertheless, it is reasonably acceptable due to reduced cost and side effects of excessive medical care due to saved ACS downstream diagnostic and therapeutic procedures. Considering that the procedure would encounter remarkable changes, due to the technologic and technical advancements, in term of reduced injection doses and required time in near future, MPS would continue to clinically serve patients with ACS.