Nuclear cardiology and electron-beam computed tomography: Competitive or complementary?

Electron-beam computed tomography (EBCT) and nuclear cardiology techniques are both valuable in the noninvasive assessment of patients with suspected coronary artery disease. The techniques, however, are different in the info rmation they provide about the patient. EBCT provides anatomic information on coronary atherosclerosis, whereas myocardial perfusion single-photon emi ssion computed tomography assesses the physiologic significance of coronary stenosis. Because of these differences, the techniques are highly compleme ntary. In considering the complementary nature of these methods, it is important t o clarify the issues being raised. An important question in the considerati on of a patient with known or suspected coronary artery disease is, What is the risk in an individual patient of developing clinical coronary artery d isease? The answer to this question will determine who needs aggressive med ical management. A second question in a suspected coronary artery disease p atient is, What is the risk of cardiac death? As will be discussed, this ri sk, in general, determines the need to consider coronary revascularization. In the former question, EBCT testing and clinical assessment alone is usua lly sufficient, and in some cases nuclear testing can be of additional valu e. In answering the second question, on the basis of currently available da ta, the EBCT and nuclear cardiology studies appear to be operating in a com plementary fashion. (C) 2001 by Excerpta Medico, Inc.