Use of Flash and DE to replace SPECT in detection of ischemia tests?

The following question has been sent by Antonio Maestro:

Use of Flash and DE to replace SPECT in detection of ischemia tests?

Hi, i am doing a research to assess the clinical and patient workflow results of using a DSCT Definition Flash for the Chest Pain Unit patients.
It seems clear to me that we can use it to rule out low risk patients, but what i am trying to suggest is the possibility of including it as the ”first choice” test to detect ischemia for patients with a non conclusive ECG.
Using the dual energy, can we get perfusion images similar to the ones that we get with SPECT? Can we replace SPECT by Def. Flash or there are not enough researches about it yet?

Thank you so much for your help
Antonio Maestro

Thorston Johnson, MD, University Hospital Munich-Grosshadern:

Yes, this is certainly very interesting. Perfusion imaging of the myocardium with DECT should work well with the new ECG-gated mode and the new hardened 140kVSn spectrum, but whether it can compete with SPECT awaits further investigation. The spatial resolution should be good; we’ll see whether the SNR is also sufficient. Go ahead – if it works, it’s great! That would give us a low-exposure single stop shop for coronary evaluation.

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