Quantitative myocardial perfusion imaging : a novel multimodality validation phantom

Abstract

Coronary artery disease (CAD) presents an enormous societal burden with respect to disease morbidity and mortality, personal hardship, and healthcare expense. In the Netherlands in 2020, the prevalence of CAD was estimated at 777,400 patients, with an increasing prevalence by age. 1,2 Over 8,000 patients die from CAD annually, whereof acute myocardial infarction covers about 60 % of deaths. 1,3 Both national and international morbidity and mortality rates have declined in the past decades due to improved risk factor management and treatment possibilities. 4 However, CAD remains one of the leading causes of death and disability worldwide. 4 In the Netherlands, CAD tops the list of disorders with the highest disease burden (expressed in disability-adjusted life years; 271,300 in 2018). 5 CAD also occurs in the top ten most expensive diseases. In 2017, CAD related cost were 2.3 billion euros, which is about 2.6 % of total national healthcare expenditure. 6 Obstructive CAD develops when coronary arteries that supply the myocardium (i.e., heart muscle) become damaged or diseased (Figure 1). Usually, coronary arteries occlude via atherosclerotic plaque development containing cholesterol deposits and HEALTHY HEART CORONARY ARTERY DISEASEFigure 1 Comparison between a healthy and coronary artery diseased heart. Regional myocardial ischemia can be the result of a flow limitation in a supplying coronary artery upstream, due to atherosclerotic plaque development.