Quantification of Coronary Flow Reserve with CZT Gamma Camera in the Evaluation of Multivessel Coronary Disease

Introduction

Evaluating patients with multivessel coronary disease using myocardial perfusion scintigraphy (MPS) remains a challenge as the extent and severity of the disease can be underestimated. This phenomenon occurs in part due to balanced ischemia and inaccuracy of traditional devices to identify small changes in coronary flow in the stress phase.^, New gamma cameras with cadmium and zinc telluride (CZT) detectors that are already commercially available have shown higher temporal and spatial resolution,^– theoretically enabling dynamic acquisition of images and calculation of myocardial blood flow (MBF) and coronary flow reserve (CFR) in an absolute way.^, This tool, whose use with positron emission tomography (PET) is already well established,^– may be promising to non invasively access three-vessel obstructive coronary artery disease (CAD) using scintigraphy and its conventional radiotracers. The objective of this case report is to describe the quantification of CFR upon diagnosis of a patient with multivessel disease whose myocardial perfusion image showed a defect not compatible with coronary angiography.

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